摘要
目的探究氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎(MPP)的疗效。方法选取遂宁市中心医院2019年3月至2022年3月收治的支原体肺炎患儿157例,简单随机化分为研究组79例、对照组78例。均给予止咳平喘、吸氧等常规治疗,对照组加阿奇霉素静脉滴注治疗,研究组加阿奇霉素联合氨溴索静脉滴注,治疗7d后,比较两组临床疗效、临床症状改善时间、肺功能[每分钟最大通气量(MVV)、最高呼气流速(PEF)、用力呼气量占用力肺活量比值(FEV1/FVC)]、免疫功能[免疫球蛋白G、A、M、E(IgG、IgA、IgM、IgE)]、血清炎症因子[血清超敏C-反应蛋白(hs-CRP)、人单核细胞趋化蛋白-4(MCP-4)、血清白细胞介素-4(IL-4)]、肺泡表面活性蛋白D(SP-D)及可溶性B7-H3(sB7-H3)水平和不良反应情况。结果治疗后,研究组患儿的临床疗效总有效率(94.94%)显著高于对照组(84.62%)(P<0.05);研究组患儿的各临床症状消失时间及MP抗体转阴时间显著少于对照组(P<0.05);两组MVV、PEF及FEV1/FVC均显著升高(P<0.05),且研究组治疗后的MVV、PEF及FEV1/FVC均显著高于对照组(P<0.05);两组IgG水平显著升高(P<0.05),IGA、IgM、IgE水平均显著降低(P<0.05),且研究组患儿治疗后IgG水平显著高于对照组(P<0.05),IgM、IgE水平均显著低于对照组(P<0.05),治疗后的IgA组间比较差异无统计学意义(P>0.05);两组hs-CRP、MCP-4、IL-4水平均显著下降(P<0.01),且研究组显著低于对照组(P<0.01);两组SP-D及sB7-H3均显著下降(P<0.01),且研究组显著低于对照组(P<0.01);治疗期间,两组均未见明显不良反应。结论氨溴索静脉滴注联合阿奇霉素治疗MPP效果显著,可有效改善肺功能、免疫炎症状态,并发症少,值得推荐。
Objective To explore the efficacy of ambroxol combined with azithromycin in treating Mycoplasma pneumoniae pneumonia(MPP)in children.Methods 157 children with mycoplasma pneumonia who were treated in Suining Central Hospital from March,2019 to March,2022 were selected and divided into the study group(79 cases)and control group(78 cases)by the simple randomization method.All children were given conventional treatments,including relieving cough and asthma and oxygen inhalation.The control group was given azithromycin intravenous infusion,while the study group was given azithromycin combined with ambroxol for intravenous infusion.After 7 days of treatment,the clinical efficacy,clinical symptom improvement time,pulmonary function[maximum minute ventilation volume(MVV),peak expiratory flow(PEF),ratio of forced expiratory volume to forced vital capacity(FEV1/FVC)],immune function[immunoglobulins G,A,M,E(IgG,IgA,IgM,IgE)],serum inflammatory factors[serum high-sensitivity C-reactive protein(hs-CRP),human monocyte chemoattractant protein-4(MCP-4),serum interleukin-4(IL-4)],alveolar surfactant protein D(SP-D)and soluble B7-H3(sB7-H3)and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of clinical efficacy(94.94%)in the study group was significantly higher than that in the control group(84.62%)(P<0.05).The disappearance time of each clinical symptom and time of negative conversion of MP antibody in the study group were significantly shorter compared with those in the control group(P<0.05).MVV,PEF and FEV1/FVC of the two groups were significantly increased(P<0.05),and MVV,PEF and FEV1/FVC in the study group after treatment were significantly higher than those in the control group(P<0.05).The IgG level of the two groups was significantly increased(P<0.05),while the levels of IGA,IgM and IgE were significantly decreased(P<0.05).After treatment,the IgG level in the study group was significantly higher than that in the control group(P<0.05),while IgM and IgE levels were significantly lower than those in the control group(P<0.05),but there was no statistical difference in IgA level between the groups after treatment(P>0.05).Levels of hs-CRP,MCP-4 and IL-4 in both groups were significantly reduced(P<0.01),and these levels were significantly lower in the study group(P<0.01).Levels of SP-D and sB7-H3 were significantly lowered in both group(P<0.01),and these two levels in the study group were significantly lower compared to the control group(P<0.01).During treatment,there were no significant adverse reactions in the two groups.Conclusion Intravenous infusion of ambroxol combined with azithromycin has a significant effect in the treatment of MPP,and it can effectively improve pulmonary function and immune inflammatory status with few complications.
作者
江明秋
沈玲
郎宁
何亚娟
王水仙
JIANG Mingqiu;SHEN Ling;LANG Ning;HE Yajuan;WANG Shuixian(Pediatric Intensive Care Unit,Suining Central Hospital,Suining 629000,China;Department of Critical Care Medicine,Suining Central Hospital,Suining 629000,China)
出处
《标记免疫分析与临床》
CAS
2024年第2期319-324,共6页
Labeled Immunoassays and Clinical Medicine
基金
四川省卫生健康委员会科研课题(编号:19PJ280)。
关键词
小儿支原体肺炎
临床症状
免疫功能
炎症因子
Mycoplasma pneumonia in children
Clinical symptoms
Immune function
Inflammatory factors