摘要
目的探析泼尼龙+阿奇霉素治疗小儿难治性支原体肺炎的临床价值。方法76例难治性支原体肺炎患儿,随机分为对照组和观察组,每组38例。对照组患儿采用阿奇霉素治疗,观察组患儿在对照组基础上加用甲泼尼龙治疗。比较两组患儿的治疗效果,不良反应发生情况,症状(咳嗽痰响、干湿性啰音、喘憋)消失时间及住院时间,治疗前后的血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平及肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和呼气流量峰值(PEF)]水平。结果观察组总有效率89.47%(34/38)高于对照组的71.05%(27/38),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)。观察组的咳嗽痰响消失时间(3.51±0.84)d、干湿性啰音消失时间(3.79±0.75)d、喘憋消失时间(3.59±0.93)d、住院时间(4.12±1.10)d均短于对照组的(5.29±1.37)、(5.72±1.38)、(5.38±1.33)、(5.09±1.21)d,差异有统计学意义(P<0.05)。治疗前,两组IL-6、TNF-α、hs-CRP水平比较差异无统计学意义(P>0.05);治疗后,观察组的IL-6、TNF-α、hs-CRP分别为(61.63±2.09)pg/ml、(1.52±0.24)pg/ml、(7.18±1.06)mg/L,均低于对照组的(120.54±2.64)pg/ml、(2.41±0.23)pg/ml、(9.32±1.49)mg/L,差异有统计学意义(P<0.05)。治疗后,观察组的FVC(3.23±0.62)L、FEV1(2.34±0.29)L、PEF(3.28±0.70)L/s均高于对照组的(2.63±0.60)L、(1.58±0.71)L、(2.45±0.67)L/s,差异有统计学意义(P<0.05)。结论难治性支原体肺炎患儿通过甲泼尼龙+阿奇霉素治疗能明显改善临床症状,减轻炎症因子反应,改善肺功能,安全性和有效性得到保障,值得临床推广。
Objective To discuss and analyze the clinical value of methylprednisolone+azithromycin in the treatment of refractory mycoplasma pneumonia in children.Methods A total of 76 children with refractory mycoplasma pneumonia were randomly divided into control group and observation group,with 38 cases in each group.The control group was treated with azithromycin,and the observation group was treated with methylprednisolone on the basis of the control group.Both groups were compared in terms of therapeutic effect,occurrence of adverse reactions,disappearance time of symptoms(cough and sputum,dry and moist rales,asthma),length of hospital stay,serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)]levels and levels of lung function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and peak expiratory flow(PEF)]before and after treatment.Results The total effective rate of the observation group was 89.47%(34/38),which was higher than that of 71.05%(27/38)of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The disappearance time of cough and sputum in the observation group was(3.51±0.84)d,the disappearance time of dry and moist rales was(3.79±0.75)d,the disappearance time of asthma was(3.59±0.93)d,and the length of hospital stay was(4.12±1.10)d,all of which were shorter than those of(5.29±1.37),(5.72±1.38),(5.38±1.33),and(5.09±1.21)d in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in IL-6,TNF-αand hs-CRP levels between the two groups(P>0.05).After treatment,the levels of IL-6,TNF-αand hs-CRP in the observation group were(61.63±2.09)pg/ml,(1.52±0.24)pg/ml and(7.18±1.06)mg/L,which were lower than those of(120.54±2.64)pg/ml,(2.41±0.23)pg/ml and(9.32±1.49)mg/L in the control
作者
敖娟娟
陶莉
许磊
AO Juan-juan;TAO Li;XU Lei(Department of Pediatrics,Xiangzhou District People's Hospital,Xiangyang 441001,China)
出处
《中国现代药物应用》
2023年第20期102-105,共4页
Chinese Journal of Modern Drug Application
关键词
难治性支原体肺炎
甲泼尼龙
阿奇霉素
小儿
炎症因子
肺功能
Refractory mycoplasma pneumonia
Methylprednisolone
Azithromycin
Children
Inflammatory factors
Lung function
