丙酸氟替卡松联合阿奇霉素治疗肺炎支原体肺炎伴慢性咳嗽患儿的效果

Effects of Fluticasone propionate combined with Azithromycin in treatment of children with mycoplasma pneumoniae pneumonia complicated with chronic cough

目的:观察丙酸氟替卡松联合阿奇霉素治疗肺炎支原体肺炎伴慢性咳嗽患儿的效果。方法:选取2019年1月至2021年1月该院收治的72例肺炎支原体肺炎伴慢性咳嗽患儿进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各36例。对照组给予阿奇霉素干混悬剂治疗,观察组在对照组基础上联合丙酸氟替卡松吸入气雾剂治疗,比较两组临床疗效、症状改善时间、住院时间、血清可溶性白细胞介素-2受体(sIL-2R)水平、C反应蛋白(CRP)水平、心肌酶谱指标[肌酸激酶同工酶(CK-MB)、天门冬氨酸转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)]水平及不良反应发生率。结果:观察组治疗总有效率为94.44%,高于对照组的77.78%,差异有统计学意义(P<0.05);治疗后,观察组sIL-2R、CRP水平均低于对照组,差异有统计学意义(P<0.05);观察组CK-MB、AST、LDH、CK水平均低于对照组,差异有统计学意义(P<0.05);观察组肺啰音消失时间、咳嗽消失时间、喘息消失时间、发热消失时间等症状改善时间和住院时间均短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丙酸氟替卡松联合阿奇霉素治疗肺炎支原体肺炎伴慢性咳嗽患儿,可提高临床疗效,降低血清sIL-2R、CRP水平及心肌酶谱指标水平,缩短临床症状恢复时间,其效果优于单纯阿奇霉素治疗。

Objective:To observe effects of Fluticasone propionate combined with Azithromycin in treatment of children with mycoplasma pneumoniae pneumonia complicated with chronic cough.Methods:A prospective study was conducted on 72 children with mycoplasma pneumoniae pneumonia complicated with chronic cough admitted to the hospital from January 2019 to January 2021.They were divided into control group and observation group according to the random number table method,36 cases in each.The control group was treated with Azithromycin dry suspension,while the observation group was treated with Fluticasone propionate inhaled aerosol on the basis of that of the control group.The clinical efficacy,the symptom improvement time and the hospitalization time,the serum soluble interleukin-2 receptor(sIL-2R)level and the C-reactive protein(CRP)level,the myocardial enzyme spectrum index levels[creatine kinase isoenzyme(CK-MB),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 94.44%,which was higher than 77.78%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of sIL-2R and CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CK-MB,AST,LDH and CK in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The improvement time of symptoms such as lung rale disappearance time,cough disappearance time,wheezing disappearance time,fever disappearance time and the hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Fluticasone combined with Azithromycin in the treatment of the children with mycoplasma pneumoniae pneumonia complicated with chronic cough can improve the clinical efficacy,reduce the levels of serum sIL-2,CRP and myocardial enzymes,and shorten the recovery time of clinical symptoms.Moreover,it is superior to single Azithromycin treatment.