摘要
目的:探讨甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎(RMPP)的疗效及对血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:按随机数字表法,将83例RMPP患儿分为两组,观察组(n=41)采用甲泼尼龙联合阿奇霉素治疗,对照组(n=42)采用阿奇霉素治疗。观察两组疗效、临床症状缓解情况以及治疗前、后1周血清CRP、TNF-α水平的变化。结果:治疗后,观察组治疗有效率高于对照组(92.68%vs.71.43%),差异有统计学意义(P<0.05);两组住院时间[(3.53±0.72)d vs.(5.32±1.35)d]、咳嗽痰响消失时间[(3.82±0.80)d vs.(5.69±1.41)d]、干湿性啰音消失时间[(5.03±1.17)d vs.(7.37±1.52)d]、喘憋消失时间[(3.65±0.90)d vs.(5.35±1.38)d]比较,观察组均短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组血清CRP[(13.58±9.67)mg/L vs.(30.73±10.54)mg/L]、TNF-α[(43.52±5.65)ng/L vs.(58.92±6.26)ng/L]比较,观察组均低于对照组,差异有统计学意义(P<0.05)。结论:甲泼尼龙联合阿奇霉素治疗可降低RMPP患儿机体炎性反应,改善临床症状,临床疗效优于单独使用阿奇霉素治疗。
Objective:To investigate the efficacy of methylprednisolone combined with azithromycin in the treatment of refractory mycoplasma pneumoniae pneumonia(RMPP)in children and its effects on serum levels of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α).Methods:83 children with RMPP were prospectively selected and divided into two groups by random number table.The observation group(n=41)was treated with methylprednisolone combined with azithromycin,and the control group(n=42)was treated with azithromycin.The curative effect,remission of clinical symptoms,changes and differences of serum CRP and TNF-αlevels before and after treatment were observed.Results:The effective rate of treatment in the observation group was higher than that in the control group(92.68%vs.71.43%),the difference was statistically significant(P<0.05).The hospitalization time[(3.53±0.72)d vs.(5.32±1.35)d],the disappearance time of cough sputum sound[(3.82±0.80)d vs.(5.69±1.41)d],the disappearance time of dry and wet rales[(5.03±1.17)d vs.(7.37±1.52)d],and the disappearance time of asthma[(3.65±0.90)d vs.(5.35±1.38)d]in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the serum CRP[(13.58±9.67)mg/L vs.(30.73±10.54)mg/L],TNF-α[(43.52±5.65)ng/L vs.(58.92±6.26)ng/L]in the observation group were lower than those in the control group,with significant difference(P<0.05).Conclusion:Methylprednisolone combined with azithromycin can reduce the inflammatory response of RMPP children and improve the clinical symptoms.The clinical effect is better than azithromycin alone.
作者
黄亚萍
邴小三
HUANG Ya-ping;BING Xiao-san(Department of Pediatrics,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang 441000,Hubei,China)
出处
《川北医学院学报》
CAS
2019年第6期683-685,689,共4页
Journal of North Sichuan Medical College
基金
湖北省自然科学基金项目(2015CBD0355)
关键词
甲泼尼龙
阿奇霉素
小儿难治性支原体肺炎
支原体
C反应蛋白
肿瘤坏死因子-α
Methylprednisolone
Azithromycin
Refractory mycoplasma pneumoniae pneumonia in children
Mycoplasma
C-reactive protein
Tumor necrosis factor-α
