阿奇霉素联合孟鲁司特钠治疗小儿肺炎支原体肺炎的效果及患儿免疫球蛋白水平分析

Effectiveness of Azithromycin Combined with Montelukast Sodium in the Treatment of Pediatric Mycoplasma Pneumoniae Pneumonia and Analysis of Immunoglobulin Levels in Children

目的研究阿奇霉素与孟鲁司特钠联用对小儿肺炎支原体肺炎(Mycoplasma Pneumoniae Pneumonia,MPP)的疗效及其对儿童免疫球蛋白含量的作用。方法随机选取2020年1月-2022年1月莆田九十五医院儿科接受治疗的60例MPP患儿作为研究对象,采用计算机随机分组法分为两组,单药组(30例)采取阿奇霉素治疗,联用组(30例)联合阿奇霉素、孟鲁司特钠进行治疗,比较两组患儿治疗效果和实验室指标变化,包括治疗总有效率、肺功能、超声特征变化情况、肺部超声(Lung Ultrasound,LUS)评分、炎性因子水平[C-反应蛋白(C-reactive Protein,CRP)、降钙素原(Procallcitonin,PCT)]、免疫球蛋白水平[免疫球蛋白A(Immunoglobu⁃lin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白E(Immunoglobulin E,IgE)]。结果联用组的治疗总有效率为96.67%,明显高于单药组的80.00%,差异有统计学意义(χ^(2)=4.043,P=0.044)。治疗后,联用组的LUS评分明显低于单药组,差异有统计学意义(P<0.05)。治疗后,联用组胸膜线异常、A线消失、肺泡间质综合征、肺实变情况明显少于单药组,差异有统计学意义(P均<0.05)。治疗后,联用组的CRP、PCT水平明显低于单药组,差异有统计学意义(P均<0.05)。治疗后,联用组的IgA水平高于单药组,IgE水平低于单药组,差异有统计学意义(P均<0.05),两组IgG水平对比,差异无统计学意义(P>0.05)。结论阿奇霉素联合孟鲁司特钠治疗MPP疗效确切,能够促进患儿肺部超声特征改善,降低炎症水平,改善免疫力。

Objective To observe the efficacy of azithromycin in combination with montelukast sodium on pediatric mycoplasma pneumoniae pneumonia(MPP)and its effect on children's immunoglobulin levels.Methods A total of 60 cases of children with MPP treated in the Department of Pediatrics of Putian 95th Hospital from January 2020 to Janu-ary 2022 were randomly selected as the study subjects,and they were divided into two groups using the computerized random grouping method.The single-drug group(30 cases)were treated with azithromycin,and the combination group(30 cases)were treated with combination of azithromycin and montelukast sodium.The total treatment effect and labo-ratory index changes of children in the two groups,including the total effective rate of treatment,lung function,changes in ultrasound characteristics,lung ultrasound(LUS)score,inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT)],immunoglobulin levels[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobu-lin E(IgE)]were compared between the two groups.Results The total treatment efficiency of the combination group was 96.67%,higher than that of the single-drug group 80.00%,and the difference was statistically significant(χ^(2)=4.043,P=0.044).After treatment,the LUS score of the combination group was significantly lower than that of the single-drug group,and the difference was statistically significant(P<0.05).After treatment,the condition of cases of pleural line abnormality,A-line disappearance,alveolar interstitial syndrome,and lung solid condition in the combi-nation group were significantly less than those in the single-drug group,and the differences were statistically signifi-cant(all P<0.05).After treatment,the CRP and PCT levels in the combination group were lower than those in the single-drug group,and the differences were statistically significant(both P<0.05).After treatment,the IgA level of the combination group was higher than that of the single-drug group,the IgE level was lower than that of the single-drug group,and the differences were statistically significant(all P<0.05),and there was no statistically significant differ-ence in IgG level between the two groups(P>0.05).Conclusion The efficacy of azithromycin combined with montelu-kast sodium in the treatment of MPP is precise,and it can promote the improvement of ultrasound characteristics of children's lungs,reduce the level of inflammation,and improve immunity.