糖皮质激素在儿童重症或难治性肺炎支原体肺炎治疗中的价值  

The efficacy of glucocorticosteroid on the treatment of severe or refractory mycoplasma pneumoniae pneumonia

作　　者：吴海飞[1] 檀卫平[1] 黄花荣[1] 吴葆菁[1] 韩明珊 欧榕琼[1] 

机构地区：[1]中山大学孙逸仙纪念医院儿科,广州510120

出　　处：《新医学》2015年第8期535-538,共4页Journal of New Medicine

摘　　要：目的探讨糖皮质激素在儿童重症和难治性肺炎支原体（MP）肺炎治疗中的作用。方法将37例2个月-14岁（中位数36个月）的重症或难治性MP肺炎患儿按照是否使用糖皮质激素分为治疗组22例、对照组15例。2组患儿入院后均常规予以口服或静脉滴注阿奇霉素,均给予吸氧、雾化吸入、体位引流等综合治疗。治疗组在上述治疗基础上予甲泼尼龙（每日2-3 mg/kg）静脉滴注3-5 d,后改泼尼松（每日1-2 mg/kg）口服并逐渐减量,维持7-10 d。比较2组临床症状改善情况、住院时间等的差异。结果所有患儿均对治疗显效,病情明显好转出院。治疗组住院时间[（8.45±3.14）d]较对照组[（11.07±2.74）d]短,总发热时间[（4.52±2.77）d]较对照组[（6.80±3.76）d]短,咳嗽好转时间[（3.48±1.37）d]亦较对照组[（4.53±1.49）d]短（P均〈0.05）。结论适量、短疗程使用糖皮质激素有助于缩短儿童重症或难治性MP肺炎的治疗时间。Objective To investigate the effect of glucocorticoid on the treatment of severe and refractory mycoplasma pneumoniae（ MP） pneumonia in children. Methods Thirty seven patients（ aged 2months - 14 years,median 36 months） with severe or refractory MP pneumonia were divided into the two groups： treatment group（ n = 22） and control group（ n = 15）. The patients in the two groups were treated with routine oral or intravenous azithromycin,and received the combined therapy including oxygen inhalation,atomization inhalation,and postural drainage. The patients in the treatment group were additionally treated with intravenous methylprednisolone（ daily,2 - 3 mg / kg） for 3 - 5 days,and then with prednisone（ daily,1 - 2mg / kg） orally and gradually reduced,maintained 7 - 10 days. Differences of clinical symptoms,and hospitalization time were compared between the two groups. Results The symptom of all the children were significantly improved,the patients＇ condition was significantly improved and discharged. The hospitalization time of the patients in the treatment group was decreased compared with that of the patients in the control group（ 8. 45 ±3. 14 vs. 11. 07 ± 2. 74,P〈0. 05）. The total duration of fever of the patients in the treatment group was shorter compared with that of the patients in the control group（ 4. 52 ± 2. 77 vs. 6. 80 ± 3. 76,P〈0. 05）. The cough improve time of the patients in the treatment group was decreased compared with that of the patients in the control group（ 3. 48 ± 1. 37 vs. 4. 53 ± 1. 49,P〈0. 05）. Conclusions The use of suitable dosage and short treatment period of corticosteroids contributes to reduce the therapy time of severe or refractory MP pneumonia in children.

关 键 词：肺炎支原体 重症 糖皮质激素 儿童 

分 类 号：R725.6[医药卫生—儿科]