摘要
目的探讨小儿肺大叶实变性重症肺炎支原体肺炎(MPP)采用阿奇霉素联合不同剂量甲强龙治疗的临床效果。方法采用随机数字表法将128例肺大叶实变性重症MPP患儿分为低剂量组(n=64)与高剂量组(n=64),在使用阿奇霉素治疗的同时,低剂量组患儿以常规剂量应用甲强龙,高剂量组患儿实施大剂量甲强龙治疗,对其临床治疗效果、免疫功能、炎性指标及不良反应分别进行比较。结果与低剂量组比较,高剂量组患儿包括咳嗽、发热、喘息、咳痰等各类症状消失时间明显缩短,治疗有效率明显提高,呼吸系统后遗症发生率明显降低,高剂量组患儿的IL-2、IL-6、IL-13、TNF-α与IFN-γ等指标均明显好转(P <0. 05);但两组患儿的Ig A、Ig M、Ig G、C3与C4水平比较差异均无统计学意义(P> 0. 05)。结论针对肺大叶实变性重症MPP患儿采用大剂量甲强龙联合阿奇霉素治疗不仅能够加快临床症状缓解与病情好转,并且可以有效抑制患儿炎症反应及远期后遗症,具有确切应用价值。
OBJECTIVE To discuss the effect of different doses of methylprednisolone combined with azithromycin in the treatment of severe pulmonary lobar degeneration in children with MPP. METHODS One hundred and twenty-eight children with severe MPP of pulmonary lobar degeneration were randomly divided into the low dose group and the high dose group with 64 cases in each group. The children of two groups were given azithromycin. On this basis,the children of low dose group were given conventional doses of methylprednisolone,the children of high dose group were given high-dose methylprednisolone. The clinical efficacy,immune function,inflammatory indexes and adverse reaction were compared. METHODS Compared with the low dose group,the disappearance time of cough,expectoration,wheezing and fever in the observation group was significantly shorter,the effective rate of the high dose group was significantly higher,the incidence of respiratory sequelae was significantly higher,the IL-2,IL-6,IL-13,TNF-α,IFN-γ in the observation group were significantly better（ P〈0. 05）. But the Ig A,Ig M,Ig G,C3 and C4 levels in the two groups were not statistically significant（ P〉0. 05）. CONCLUSION Large dose of methylprednisolone combined with azithromycin can relieve the clinical symptoms of severe MPP in children with lobar degeneration. It also can promote the rehabilitation of the disease,effectively inhibit the inflammatory response of children and long-term sequelae,has the exact application value.
作者
陈恒
吴云刚
CHEN Heng;WU Yun-gang(Department of Pediatrics,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Pediatric,Nanshi Hospital of Nanyang,Nanyang 473000,China)
出处
《中国药学杂志》
CAS
CSCD
北大核心
2018年第20期1799-1802,共4页
Chinese Pharmaceutical Journal
