孟鲁司特钠联合红霉素治疗小儿肺炎支原体感染的效果观察

Efficacy of montelukast combined with erythromycin in the treatment of children with Mycoplasma pneumoniae infection

目的 观察孟鲁司特钠联合红霉素对小儿肺炎支原体感染的临床疗效及其对患儿肺功能、血清应激指标水平的影响情况。方法 选取94例小儿肺炎支原体感染患儿作为研究对象,随机分成对照组和观察组,每组47例。在常规治疗基础上,对照组采用红霉素治疗,观察组采用红霉素联合孟鲁司特钠咀嚼片治疗。观察2组患儿治疗后临床疗效、临床症状消失时间和不良反应发生情况,并观察2组患儿治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、用力肺活量(FVC)]、血清应激指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]变化情况。结果 观察组患儿总有效率为97.87%,高于对照组的89.36%,但差异无统计学意义(P>0.05);观察组患儿总显效率为76.60%,高于对照组的55.32%,差异有统计学意义(P<0.05)。观察组患儿发热、咳嗽、肺部啰音消失时间依次为(3.21±0.75)、(6.77±1.52)、(4.57±1.19) d,分别短于对照组的(3.68±0.81)、(8.02±1.88)、(5.38±1.36) d,差异有统计学意义(P<0.05)。治疗后,2组FEV_(1)、PEF、FVC水平均高于治疗前,且观察组水平高于对照组,差异有统计学意义(P<0.05)。治疗后,2组患儿TNF-α、IL-6、CRP水平均低于治疗前,且观察组患儿TNF-α、CRP水平低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为12.77%,低于对照组的17.02%,但差异无统计学意义(P>0.05)。结论 相较于单独使用红霉素,孟鲁司特钠联合红霉素对小儿肺炎支原体感染的治疗效果更优,可显著缩短患儿发热、咳嗽等症状消失时间,显著改善肺功能指标和机体内血清应激指标水平。

Objective To observe the clinical efficacy of montelukast combined with erythromycin in the treatment of children with Mycoplasma pneumoniae infection and its effect on pulmonary function and serum stress indexes.Methods A total of 94 children with Mycoplasma pneumoniae were selected as study objects,and were randomly divided into observation group and control group,with 47 cases in each group.The control group was given conventional drug treatment and erythromycin treatment;the observation group was given combined treatment with montelukast sodium chewable tablet based on the control group.The clinical efficacy after treatment,the disappear time of clinical symptoms,and the occurrence of adverse reactions of the two groups were observed.The changes of pulmonary function indexes [forced expiratory volume in the first second(FEV_(1)),peak expiratory flow(PEF),forced vital capacity(FVC)],serum stress indexes [tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)] before and after treatment in the two groups were observed.Results The total effective rate in the observation group was higher than that of the control group(97.87% versus 89.36%,P>0.05).The total remarked rate of the observation group was higher than that of control group,and the difference was statistically significant(76.60% versus 55.32%,P 0.05).The disappearance time of fever,cough and lung rale in the observation group was( 3.21 ± 0.75) d,( 6.77 ± 1.52) d and( 4.57 ± 1.19) d,which were shorter than( 3.68 ±0.81) d,( 8.02 ± 1.88) d and( 5.38 ± 1.36) d,respectively in the control group( P< 0.05).After treatment,the levels of FEV_(1),PEF and FVC in two groups were higher than before treatment,and their levels in the observation group were higher than control group( P <0.05).After treatment,the levels of TNF-α,IL-6 and CRP in two groups were lower than before treatment,and their levels in the observation group were lower than those in the control group( P <0.05).The adverse reaction rate in the observation group was slightly lower than that in the control group,but no significant differences were observed( 12.77% versus 17.02%,P>0.05).Conclusion Montelukast combined with erythromycin in the treatment of children with Mycoplasma pneumoniae infection has better clinical efficacy than erythromycin alone,and can significantly shorten the disappearance time of fever,cough and other symptoms in children,and significantly improve the level of lung function indexes and serum stress indexes in the body.