阿奇霉素联合甲泼尼龙琥珀酸钠治疗小儿难治性肺炎支原体肺炎的临床效果

Clinical Effect of Azithromycin Combined with Methylprednisolone Sodium Succinate in the Treatment of Refractory Mycoplasma Pneumoniae Pneumonia in Children

目的:探讨阿奇霉素联合甲泼尼龙琥珀酸钠治疗小儿难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)的临床效果。方法:选取2021年6月—2023年6月南通市通州区人民医院儿科收治的90例RMPP患儿作为研究对象。根据随机数表法将其分为观察组和对照组,各45例。对照组给予阿奇霉素,观察组在对照组基础上给予甲泼尼龙琥珀酸钠。比较两组临床疗效、时间指标、治疗前后实验室指标、不良反应。结果:观察组总有效率为91.11%,高于对照组的71.11%,差异有统计学意义(P<0.05)。观察组咳嗽停止时间、啰音消失时间、体温正常时间均早于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组C反应蛋白(C-reactive protein,CRP)水平、降钙素原(procalcitonin,PCT)水平、白细胞计数(white blood cell count,WBC)及中性粒细胞百分比(percentage of neutrophil,NE%)均降低,观察组WBC、CRP、PCT及NE%均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:甲泼尼龙琥珀酸钠联合阿奇霉素治疗小儿RMPP能够有效缩短患儿各项症状改善时间,改善炎症指标,二药联合具有提升临床疗效的协同作用,同时也不会增加不良反应,具有较好的安全性。

Objective:To explore the clinical effect of Azithromycin combined with Methylprednisolone Sodium Succinate in the treatment of refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Method:A total of 90 children with RMPP admitted to the Department of Pediatrics of Tongzhou District People's Hospital,Nantong City from June 2021 to June 2023 were selected as the study objects.They were divided into observation group and control group according to random number table method,45 cases in each group.The control group was given Azithromycin,and the observation group was given Methylprednisolone Sodium Succinate based on the control group.The clinical efficacy,time index,laboratory index before and after treatment,adverse reactions were compared between the two groups.Result:The total effective rate of the observation group was 91.11%,which was higher than 71.11%of the control group,and the difference was statistically significant(P<0.05).Cough cessation time,rales disappearance time and normal temperature time in observation group were earlier than those in control group,and hospital stay was shorter than that in control group,the differences were statistically significant(P<0.05).After treatment,the levels of C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC)and percentage of neutrophils(NE%)in the two groups decreased,WBC,CRP,PCT and NE%in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Methylprednisolone Sodium Succinate combined with Azithromycin in the treatment of RMPP in children can effectively shorten the improvement time of various symptoms and improve inflammatory indicators.The combination of the two drugs has a synergistic effect of improving clinical efficacy,but does not increase adverse reactions,and has a good safety.