小剂量糖皮质激素治疗儿童肺炎支原体感染性大叶性肺炎的效果观察

Effect Observation of Low-Dose Glucocorticoid in Treatment of Lobar Pneumonia Caused by Mycoplasma Pneumoniae in Children

目的:探讨小剂量糖皮质激素治疗儿童肺炎支原体感染性大叶性肺炎的效果。方法:选取2021年3月—2022年3月沭阳仁慈医院收治的76例肺炎支原体感染性大叶性肺炎患儿作为研究对象,根据随机数字表法分为对照组与观察组,各38例。对照组给予常规治疗,观察组在对照组基础上给予小剂量糖皮质激素治疗。比较两组治疗效果。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.042)。观察组咳嗽消失、体温恢复正常、胸部阴影消退、肺部啰音消失时间均短于对照组,差异有统计学意义(P<0.001)。治疗前,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平比较,差异无统计学意义(P>0.05);治疗后,观察组IL-6、CRP、TNF-α、PCT水平低于对照组,差异有统计学意义(P<0.001)。治疗前,两组用力肺活量(FVC)、第1 s用力呼气容积(FEV1)、呼气流量峰值(PEF)比较,差异无统计学意义(P>0.05);治疗后,观察组FVC、FEV1、PEF高于对照组,差异有统计学意义(P<0.001)。结论:肺炎支原体感染性大叶性肺炎患儿给予小剂量糖皮质激素治疗,有助于患儿临床症状、炎性反应、肺功能改善。

Objective:To explore the effect of low-dose glucocorticoid in the treatment of lobar pneumonia caused by mycoplasma pneumoniae in children.Methods:From March 2021 to March 2022,76 children with lobar pneumonia caused by mycoplasma pneumoniae who were admitted to Shuyang Renci Hospital were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 38 cases in each group.The control group was given routine treatment and the observation group was given low-dose glucocorticoid treatment on the basis of control group.The treatment effect was compared between the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.042).The time of cough disappearance,body temperature returning to normal level,chest shadow resolution,and pulmonary rale disappearance in the observation group were all shorter than those in the control group,and the difference was statistically significant(P<0.001).Before treatment,there was no significant difference in the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)between the two groups(P>0.05).After treatment,the levels of IL-6,CRP,TNF-αand PCT in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001).Before treatment,there were no significant differences in forced vital capacity(FVC),forced expiratory volume in 1 s(FEV1)and peak expiratory flow(PEF)between the two groups(P>0.05).After treatment,FVC,FEV1 and PEF in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.001).Conclusion:Low-dose glucocorticoid treatment for children with lobar pneumonia caused by mycoplasma pneumoniae is helpful to improve the clinical symptoms,inflammatory reaction and pulmonary function of children.