不同剂量甲泼尼龙辅治小儿支原体肺炎对其肺功能改善及预后的影响研究

Effects of different doses of methylprednisolone on improvement of lung function and prognosis of mycoplasma pneumonia in children

目的探讨小剂量和大剂量甲泼尼龙辅助治疗小儿支原体肺炎的临床效果及其肺功能改善和预后影响情况。方法选择2018年10月~2021年10月接诊的小儿支原体肺炎106例患儿为研究对象,按照随机数表法将其分为小剂量组(n=53)和大剂量组(n=53),两组均进行常规治疗,小剂量组在常规治疗基础上选择甲泼尼龙辅助治疗,剂量为2 mg/(kg·d),大剂量组在常规治疗基础上选择甲泼尼龙辅助治疗,剂量为10 mg/(kg·d)。对比两组辅助治疗后的临床疗效、肺功能情况[动脉血氧分压(PaO_(2))、有氧合指数(PaO_(2)/FiO_(2))]、临床症状及用药安全性。结果小剂量组患儿辅助治疗后的总有效率高于大剂量组患儿(88.68%vs.69.81%)(P<0.05);小剂量组患儿咳嗽消失时间、退热时间、体温正常时间、肺部啰音消失时间、X线肺部阴影消失时间及住院总天数均低于大剂量组患儿(P<0.05);小剂量组患儿肺功能PaO_(2)、PaO_(2)/FiO_(2)水平均高于大剂量组患儿(P<0.05),小剂量组患儿辅助治疗后总不良反应率低于大剂量组患儿(13.21%vs.32.07%)(P<0.05)。结论大剂量和小剂量甲泼尼龙辅助治疗小儿支原体肺炎患儿的临床效果较为显著,但相较于大剂量,小剂量甲泼尼龙辅助治疗的效果更佳,能明显改善肺功能、临床症状及缩短住院时间,且安全性高。

Objective To investigate the clinical effect of low-dose and high-dose methylprednisolone in the adjuvant treatment of mycoplasma pneumonia in children and the effect of lung function improvement and prognosis.Methods A total of 106 children with mycoplasma pneumonia treated in our hospital from October 2018 to 2021 were selected as the research objects.According to the random number table method,they were divided into low-dose group(n=53)and high-dose group(n=53).Both groups received conventional treatment,and the low-dose group received methylprednisolone adjuvant treatment based on conventional treatment.The dose was 2 mg/(kg·d),and the high-dose group was treated with methylprednisolone[10 mg/(kg·d)]in addition to conventional treatment.Clinical efficacy,pulmonary function[PaO_(2)/FiO_(2)],clinical symptoms and drug safety were compared between the two groups after adjuvant therapy.Results The total effective rate in low-dose group was higher than that in high-dose group(88.68%vs.69.81%)(P<0.05).The disappearance time of cough,antipyretic time,normal temperature time,lung rales disappearance time,X-ray lung shadow disappearance time and total hospitalization days in the low-dose group were lower than those in the high-dose group(P<0.05).The levels of PaO_(2) and PaO_(2)/FiO_(2) in lung function in the low-dose group were higher than those in the high-dose group(P<0.05).The rate of total adverse reactions in the low-dose group was lower than that in the high-dose group(13.21%vs.32.07%)(P<0.05).Conclusion The clinical effect of high-dose and low-dose methylprednisolone in the adjuvant treatment of mycoplasma pneumonia in children is relatively significant,but compared with the high-dose,the effect of low-dose methylprednisolone in the adjuvant treatment is better,such as significantly improving lung function,clinical symptoms and shortening hospital stay,and the safety is high.