米诺环素对耐阿奇霉素重症支原体肺炎患儿炎症反应及凝血功能的影响

Effect of minocycline on inflammation and coagulation in children with severe mycoplasma pneumonia resistant to azithromycin

目的探究米诺环素对耐阿奇霉素重症支原体肺炎患儿炎症反应及凝血功能的影响。方法选取2023年1至12月期间北京市通州区妇幼保健院收治的112例重症支原体肺炎患儿进行分析,根据治疗方案差异分为观察组(n=60)与对照组(n=52)。对照组予以常规对症治疗,观察组使用米诺环素治疗。比较两组的临床疗效、治疗后的症状改善情况(肺部啰音消失时间、喘息消失时间、咳嗽缓解时间、肺部阴影消失时间)以及治疗期间的不良反应情况;比较两组治疗前后的炎症指标水平[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、降钙素原(PCT)]以及凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血浆D-二聚体(D-D)、凝血酶时间(TT)]。结果两组临床疗效对比,观察组总有效率显著更高,差异有统计学意义(χ^(2)=7.078,P<0.05);观察组治疗后的症状改善情况明显优于对照组,差异有统计学意义(t=23.453、9.751、16.711、10.479,P<0.05);治疗后,两组炎症指标PCT、NLR及PLR水平均较治疗前显著降低,且观察组更低,差异有统计学意义(t=17.371、7.020、13.406,P<0.05);两组凝血功能指标较治疗前均显著降低,且观察组更低,差异有统计学意义(t=4.649、10.220、18.009、9.922、9.051,P<0.05);两组不良反应情况比较差异无统计学意义(χ^(2)=0.027,P>0.05)。结论针对耐阿奇霉素重症支原体肺炎患儿应用米诺环素的疗效显著且安全性良好,可能与其调节机体内凝血功能及炎症相关因子有关。

Objective To explore the effects of minocycline on inflammation and coagulation function in children with severe mycoplasma pneumonia resistant to azithromycin.Methods A total of 112 children with severe mycoplasma pneumonia were admitted to Tongzhou District Maternal and Child Health Hospital in Beijing from January to December 2023.They were included in the analysis and divided into an ob-servation group(n=60)and a control group(n=52)based on their difference in treatment regimen.The con-trol group received conventional symptomatic treatment,while the observation group was treated with minocy-cline.The clinical efficacy,symptom improvement after treatment(rales disappear time,wheezing disappear time,cough relief time,and lung shadow disappearance)and adverse reactions during treatment were com-pared between the two groups.The levels of inflammatory indicators neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),procalcitonin(PCT)and coagulation function(prothrombin time(PT)),activated partial thromboplastin time(APTT),fibrinogen(FIB),plasma D-dimer(D-D)and coagulation blood enzyme time(TT)were compared between the two groups before and after treatment.Results The to-tal effective rate of the observation group was significantly higher than that of the other two groups(χ^(2)=7.078,P<0.05).The improvement of symptoms in the observation group after treatment was significantly better than that in the control group,and the difference was statistically significant(t=23.453,9.751,16.711,10.479,P<0.05).After treatment,the levels of inflammatory indicators PCT,NLR,and PLR in both groups were mark-edly lower than before treatment,and those in the observation group were even lower,with statistical signifi-cance(t=17.371,7.020,13.406,P<0.05).The index of coagulation function in both groups was significantly lower than before treatment,and that of the observation group was lower,and the difference was statistically significant(t=4.649,10.220,18.009,9.922,9.051,P<0.05).There was no significant difference in adverse reactions between the two groups(χ^(2)=0.027,P>0.05).Conclusion Minocycline is both effective and safe for children with severe mycoplasma pneumonia who are resistant to azithromycin.This may be due to its abil-ity to regulate coagulation function and inflammation-related factors in the body.