阿奇霉素治疗支原体肺炎无效患儿的临床特征研究

Clinical Characteristics Study of Azithromycin in Treatment of Ineffective Children with Mycoplasma Pneumonia

目的:研究阿奇霉素治疗5~7 d无效的肺炎支原体肺炎(MPP)患儿临床特征。方法:回顾性分析我院259例MPP患儿临床资料,根据对初始采用阿奇霉素治疗5~7 d的反应,分为“有效组”和“无效组”,对比分析患儿的临床表现、实验室检查和并发症等。结果:阿奇霉素治疗有效组218例(218/259,84.17%),无效组41例(41/259,15.83%)。治疗无效组患儿发热热程(13.34±5.41 d)明显高于治疗有效组(7.82±2.10 d),无效组住院时间(16.07±7.43d)也较治疗有效组(8.53±1.90)长。比较两组C-反应蛋白、血清铁蛋白、白介素-6、乳酸脱氢酶、D二聚体均明显高于有效组(P<0.01)。而白细胞计数和降钙素原两组之间无差异,P>0.05。阿奇霉素治疗无效组出现皮疹、肝损伤、栓塞、闭塞性支气管炎、胸腔积液及纤维支气管镜下黏膜坏死等的并发症明显高于治疗有效组。结论:阿奇霉素治疗无效组的MPP患儿,C-反应蛋白、白介素-6、血清铁蛋白、乳酸脱氢酶、D二聚体均明显高于有效组,临床应重视以上相关指标,做到早期识别,减少并发症的发生。

Objective:To summarize the clinical characteristics of children with MPP who did not respond to azithromycin.Methods:The clinical data of 259 children with MPP were retrospectively analyzed.According to their response to azithromycin treatment,they were divided into"effective"and"ineffective"group.Their clinical manifestations,laboratory tests and complications were compared.Results:There were 218 cases in the effective group and 41 cases in the ineffective group.The duration of heat in the ineffective group(13.34±5.41 d)was significantly higher than that in the effective group(13.34±5.41 d),and the length of hospital stay(16.07±7.43 d)was longer than that in the effective group(8.53±1.90 d).Compare the two groups of CRP,SF,interleukin-6,LDH,D-D were significantly higher than the effective group.While the WBC and procalcitonin there was no difference between the two groups.The complications of rash,liver injury,embolism,bronchitis obliterans,pleural effusion and mucous membrane necrosis under fibrobronchoscopy were significantly higher in the azithromycin ineffective group.Conclusion:The levels of CRP,interleukin-6,SF,LDH and D-D in children with MPP who did not respond to azithromycin treatment were significantly higher than those in the effective group,and the common complications were significantly higher than those in the effective group.