布地奈德联合甲泼尼龙治疗难治性支原体肺炎患儿的疗效观察

Efficacy of budesonide combined with methylprednisolone in the treatment of children with refractory Mycoplasma pneumonia

目的分析布地奈德+甲泼尼龙治疗难治性肺炎支原体肺炎(RMPP)的临床疗效。方法80例RMPP患儿,按照1︰1比例分为观察组与对照组,各40例。对照组采取布地奈德雾化吸入治疗,观察组采取布地奈德雾化吸入+甲泼尼龙治疗。比较两组临床疗效、相关指标[症状消失时间、血清C反应蛋白(CRP)、白细胞计数(WBC)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)水平]。结果观察组的治疗总有效率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。观察组咳嗽、发热、肺啰音消失时间分别为(5.20±0.50)、(2.60±0.50)、(6.50±0.80)d,均短于对照组的(5.90±0.60)、(3.05±0.60)、(7.20±1.20)d,CRP、WBC、IgA、IgM、IgG水平分别为(17.20±5.60)mg/L、(9.50±1.60)×10^(9)/L、(0.95±0.15)g/L、(1.02±0.10)g/L、(6.80±1.20)g/L,均低于对照组的(21.50±6.50)mg/L、(11.30±2.20)×10^(9)/L、(1.15±0.20)g/L、(1.12±0.13)g/L、(7.50±1.30)g/L,差异有统计学意义(P<0.05)。结论布地奈德、甲泼尼龙联合治疗RMPP效果显著,可以促进患儿症状体征改善,提高免疫功能,是优选联合治疗方案。

Objective To analyze the clinical efficacy of budesonide combined with methylprednisolone in the treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 80 children with RMPP were divided into observation group and control group according to the ratio of 1︰1,with 40 cases in each group.Children in the control group were treated with budesonide aerosol inhalation,and children in the observation group were treated with budesonide aerosol inhalation+methylprednisolone.The clinical efficacy,related indicators[symptom disappearance time,serum C-reactive protein(CRP),white blood cell count(WBC),immunoglobulin A(IgA),immunoglobulin M(IgM),and immunoglobulin G(IgG)]were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than 80.00%in the control group,and the difference was statistically significant(P<0.05).The disappearance times of cough,fever and pulmonary rales in the observation group were(5.20±0.50),(2.60±0.50),and(6.50±0.80)d,which were shorter than(5.90±0.60),(3.05±0.60),and(7.20±1.20)d in the control group;the CRP,WBC,IgA,IgM,and IgG levels were(17.20±5.60)mg/L,(9.50±1.60)×10^(9)/L,(0.95±0.15)g/L,(1.02±0.10)g/L,and(6.80±1.20)g/L,which were all lower than(21.50±6.50)mg/L,(11.30±2.20)×10^(9)/L,(1.15±0.20)g/L,(1.12±0.13)g/L,and(7.50±1.30)g/L in the control group;all the differences were statistically significant(P<0.05).Conclusion The combination of budesonide and methylprednisolone has a significant effect in the treatment of RMPP,which can promote the improvement of children's symptoms and signs,and improve the immune function.It is the preferred combination therapy.