探讨阿奇霉素和红霉素在小儿肺炎支原体肺炎治疗中的临床效果

The clinical effect of azithromycin and erythromycin in the treatment of mycoplasma pneumoniae pneumonia in children

目的探究小儿肺炎支原体肺炎治疗中应用阿奇霉素和红霉素的临床效果。方法甄选小儿肺炎支原体肺炎患儿50例实施研究,经随机数字表法分为对照组和观察组,每组25例。对照组给予红霉素治疗,观察组给予阿奇霉素治疗。比较两组治疗效果、咳嗽评分和咳嗽消失时间、炎症因子水平、肺功能、临床症状改善时间及住院时间。结果治疗前两组咳嗽评分比较,差异无统计学意义(P>0.05);治疗后,两组咳嗽评分均较治疗前降低,且观察组咳嗽评分(0.61±0.03)分低于对照组的(1.03±0.07)分(P<0.05)。观察组咳嗽消失时间(6.84±1.29)d短于对照组的(10.54±2.01)d,差异有统计学意义(P<0.05)。观察组临床总有效率是96.00%,明显高于对照组的72.00%,差异有统计学意义(P<0.05)。治疗前两组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)水平差异无统计学意义(P>0.05);治疗后,两组CRP、TNF-α均较治疗前降低,IL-10较治疗前升高,且观察组CRP(7.19±1.13)mg/L、TNF-α(5.97±2.08)µg/L均低于对照组的(10.40±1.42)mg/L、(9.63±3.72)µg/L,IL-10(158.47±15.33)ng/L高于对照组的(127.80±12.39)ng/L,差异有统计学意义(P<0.05)。治疗前两组的最长呼气时间、每分钟最大通气量(MVV)、第1秒用力呼气容积(FEV1)占预计值百分比比较,差异无统计学意义(P>0.05);治疗后,两组最长呼气时间、MVV、FEV1占预计值百分比高于治疗前,且观察组的最长呼气时间(8.48±0.88)d长于对照组的(4.50±0.46)d,MVV(81.65±7.16)L、FEV1占预计值百分比(83.20±5.26)%大于对照组的(71.97±6.40)L、(74.93±3.95)%,差异有统计学意义(P<0.05)。和对照组的退热时间(7.52±2.06)d、肺阴影消失时间(10.22±2.43)d、住院时间(11.24±2.11)d比较,观察组的(3.83±1.03)、(7.41±1.29)、(9.35±2.11)d显著较短,差异有统计学意义(P<0.05)。结论小儿肺炎支原体肺炎应用阿奇霉素治疗的临床效果优于红霉素,利于改善患儿咳嗽症状,同时可有效改善患儿炎症因子水平和肺功能,值得推广应用。

Objective To investigate the clinical effect of azithromycin and erythromycin in the treatment of mycoplasma pneumoniae pneumonia in children.Methods 50 children with mycoplasma pneumoniae pneumonia were selected and divided into a control group and an observation group by random number table method,with 25 cases in each group.The control group was treated with erythromycin,and the observation group was treated with azithromycin.The therapeutic effect,cough score,cough disappearance time,inflammatory factor level,lung function,clinical symptom improvement time and length of hospital stay were compared between the two groups.Results Before treatment,there was no significant difference in cough score between the two groups(P>0.05).After treatment,the cough score in both groups decreased compared with that before treatment;the observation group had lower cough score of(0.61±0.03)points than(1.03±0.07)points in the control group(P<0.05);the observation group had shorter cough disappearance time of(6.84±1.29)d than(10.54±2.01)d in the control group,and the difference was statistically significant(P<0.05).The total clinical effective rate of the observation group was 96.00%,which was significantly higher than 72.00%of the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)levels between the two groups(P>0.05).After treatment,CRP and TNF-αdecreased and IL-10 increased in both groups compared with those before treatment;the observation group had CRP of(7.19±1.13)mg/L and TNF-αof(5.97±2.08)µg/L,which were lower than(10.40±1.42)mg/L and(9.63±3.72)µg/L in the control group;the observation group had higher IL-10 of(158.47±15.33)ng/L than(127.80±12.39)ng/L in the control group;the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the maximum expiratory time,maximum voluntary ventilation(MVV)and forced expiratory volume in one second(FEV1)as a percentage of the predicted value between the two groups(P>0.05).After treatment,the maximum expiratory time,MVV,FEV1 as a percentage of the predicted value in both groups were higher than those before treatment;the observation group had longer maximum expiratory time of(8.48±0.88)d than(4.50±0.46)d in the control group;the observation group had MVV of(81.65±7.16)L and FEV1 as a percentage of the predicted value of(83.20±5.26)%,which were higher than(71.97±6.40)L and(74.93±3.95)%in the control group;the difference was statistically significant(P<0.05).In the control group,the time of fever reduction was(7.52±2.06)d,the disappearance time of lung shadow was(10.22±2.43)d and the length of hospital stay was(11.24±2.11)d,and those in the observation group were(3.83±1.03),(7.41±1.29)and(9.35±2.11)d;the observation group was significant shorter,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of azithromycin in the treatment of mycoplasma pneumoniae pneumonia in children is better than erythromycin,which is conducive to improving the cough symptoms of children,and can effectively improve the level of inflammatory factors and lung function in children,which is worthy of promotion and application.