阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床效果

Clinical effect of azithromycin sequential therapy on mycoplasma pneumoniae pneumonia in children

目的 观察阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床效果。方法 选取2022年2月—2023年2月广州市花都区妇幼保健院收治的肺炎支原体肺炎患儿84例,按照单双号数字抽签法分为序贯组与常规组,各42例。常规组应用常规治疗+红霉素序贯疗法,序贯组应用常规治疗+阿奇霉素序贯疗法,治疗后比较2组临床疗效、临床症状与体征消失时间及治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰值流量(PEF)]、炎性因子[血清C反应蛋白(CRP)、降钙素原(PCT)]、免疫指标[免疫球蛋白A、G、M(IgA、IgG、IgM)]水平。结果 序贯组治疗总有效率为97.62%,高于常规组的80.95%(χ^(2)=4.480,P=0.034);序贯组咳嗽咯痰、发热、肺部湿啰音、呼吸困难消失时间均短于常规组(P<0.01);治疗7 d后,2组FEV_(1)、FEV_(1)/FVC、PEF均大于治疗前,且序贯组大于常规组(P<0.01);2组血清CRP、PCT及IgA、IgG、IgM水平均低于治疗前,且序贯组低于常规组(P<0.01)。结论 阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎效果较好,可较快改善临床症状及肺功能,改善炎性反应,提高患儿免疫功能。

Objective To observe the clinical effect of azithromycin sequential therapy on mycoplasma pneumoniae pneumonia in children.Methods A total of 84 children with mycoplasma pneumoniae pneumonia admitted to Guangzhou Huadu District Maternal and Child Health Hospital from February 2022 to February 2023 were selected and divided into sequential group and conventional group according to drawing method,with 42 cases in each group.The conventional group received conventional treatment plus sequential therapy with erythromycin,while the sequential group received conventional treatment plus sequential therapy with azithromycin.The clinical efficacy,disappearance time of clinical symptoms and signs,pulmonary function indexes[forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),Peak expiratory flow(PEF)],levels of inflammatory factors[serum C-reactive protein(CRP),procalcitonin(PCT)],and immune indexes[immunoglobulin A,G,M(IgA,IgG,IgM)]before and after treatment were compared between the two groups.Results The total effective rate of the sequential group was 97.62%,which was higher than 80.95%of the conventional group(χ^(2)=4.480,P=0.034).The disappearance time of cough,phlegm,fever,moist rales and dyspnea in sequential group were shorter than those in conventional group(P<0.01).After treatment,FEV_(1),FEV_(1)/FVC and PEF in two groups were higher than before treatment,and the sequential group was higher than the conventional group(P<0.01).The levels of serum CRP,PCT,IgA,IgG and IgM in two groups were lower than before treatment,and those in sequential group were lower than those in conventional group(P<0.01).Conclusion Azithromycin sequential therapy is effective in the treatment of mycoplasma pneumoniae pneumonia in children,which can quickly improve clinical symptoms and lung function,improve inflammatory response,and enhance immune function of children.