孟鲁司特钠联合阿奇霉素治疗儿童重症支原体肺炎的疗效及对肺通气功能的影响

Efficacy of montelukast sodium combined with azithromycin in the treatment of severe mycoplasma pneumonia in children and its effect on pulmonary ventilation function

目的 观察孟鲁司特钠联合阿奇霉素治疗儿童重症支原体肺炎的疗效及对肺通气功能的影响。方法 回顾性选取2021年1月—2023年1月南昌大学第二附属医院收治的重症支原体肺炎患儿60例,根据治疗方法不同分为观察组和对照组,每组30例。对照组给予阿奇霉素治疗,观察组在对照组治疗基础上给予孟鲁司特钠治疗,2组均治疗2个疗程。比较2组患儿临床疗效,治疗前后肺通气功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))/FVC、最大呼气中期流速(MMEF)、用力呼出75%肺活量时的瞬间流量(FEF75)及最大通气量(MVV)]、免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、降钙素原(PCT)]水平。结果 观察组患儿总有效率为100.00%,高于对照组的80.00%(χ^(2)=4.631,P=0.031)。治疗2个疗程后,2组患儿FVC、FEV_(1)/FVC、MMEF、FEF75及MVV均高于治疗前,且观察组高于对照组(P<0.01);2组患儿IgA、IgG、IgM水平均低于治疗前,且观察组低于对照组(P<0.01);2组患儿CD4^(+)、CD4^(+)/CD8^(+)均高于治疗前,CD8^(+)低于治疗前,且观察组高/低于对照组(P<0.01);2组患儿hs-CRP、IL-6、PCT水平均低于治疗前,且观察组低于对照组(P<0.05或P<0.01)。结论 孟鲁司特钠联合阿奇霉素治疗儿童重症支原体肺炎的临床疗效较好,可显著改善患儿肺通气功能及免疫功能,降低炎性反应。

Objective To observe the curative effect of montelukast sodium combined with azithromycin in the treatment of severe mycoplasma pneumonia in children and the effect on pulmonary ventilation function.Methods Sixty cases of severe mycoplasma pneumonia in children admitted to the Second Affiliated Hospital of Nanchang University from January 2021 to January 2023 were retrospectively selected and divided into observation group and control group according to different treatment methods,with 30 cases in each group.The control group was treated with azithromycin,and the observation group was treated with montelukast sodium on the basis of the control group.Both groups were treated for 2 courses.The clinical efficacy,levels of pulmonary ventilation function[forced vital capacity(FVC),forced respiration volume in the first second(FEV_(1)),rate in the first second(FEV_(1)/FVC),maximum mid-expiratory flow rate(MMEF),instantaneous flow rate in forced exhalation of 75%of vital capacity(FEF 75)and maximum volume of air(MVV)],immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),procalcitonin(PCT)]before and after treatment between the two groups were compared.Results The total effective rate of observation group was 100.00%,which was higher than that of control group 80.00%(χ^(2)=4.631,P=0.031).After 2 courses of treatment,FVC,FEV_(1)/FVC,MMEF,FEF 75 and MVV in 2 groups were higher than before treatment,and the observation group was higher than the control group(P<0.01).The levels of IgA,IgG and IgM in 2 groups were lower than before treatment,and the observation group was lower than the control group(P<0.01).CD4^(+)and CD4^(+)/CD8^(+)in 2 groups were higher than before treatment,CD8^(+)were lower than before treatment,and the observation group was higher lower than control group(P<0.01).The levels of hs-CRP,IL-6 and PCT in 2 groups were lower than before treatment,and the observation group was lower than the control group(P<0.05 or P<0.01).Conclusion Montelukast sodium combined with azithromycin in the treatment of severe mycoplasma pneumonia in children has good clinical efficacy,can significantly improve the pulmonary ventilation function and immune function,reduce inflammatory response.