大环类酯类抗生素联合支气管扩张剂和皮质激素吸入治疗MP感染引发小儿哮喘的临床效果观察  

Study on the efficacy of macrolide combined with bronchodilator and inhalation of corticosteroids in treatment of asthma in pediatric patients caused by infection of Mycoplasma pneumonia

作　　者：何冬梅 

机构地区：[1]四川省成都市温江区妇幼保健院儿科,四川成都611130

出　　处：《临床和实验医学杂志》2015年第18期1499-1502,共4页Journal of Clinical and Experimental Medicine

基　　金：2011四川省卫生厅科研课题(编号:110607)

摘　　要：目的探讨肺炎支原体(MP)感染引发小儿哮喘采用大环内脂类抗生素(阿奇霉素)联合支气管扩张剂和糖皮质激素治疗的临床效果。方法随机将2011年7月至2014年4月收治的98例MP感染致哮喘患儿分为研究组和对照组各49例。研究组采用阿奇霉素联合β2受体兴奋剂和糖皮质激素进行治疗,对照组采用阿奇霉素联合β2受体兴奋剂进行治疗。观察并记录两组患儿咳嗽消失时间、最大峰流速、治疗3 d后临床症状表现(发热、肺部炎症、肺部啰音、肺部哮鸣音、间质性肺炎、支气管肺炎)发生率的变化情况、平均住院时间、复发率、MP-Ig M抗体、复发时间等指标。结果治疗3 d后研究组患儿的发热、肺部啰音、肺部哮鸣音发生率均显著的低于对照组(P<0.05);咳嗽消失时间、住院时间显著短于对照组,最大峰流速显著高于对照组,复发出现的时间显著长于对照组,且以上差异均具有统计学意义(P<0.05);复发率、MP-Ig M抗体阳性率均高于对照组,但差异无显著性(P>0.05)。研究组的疗效分布显著的优于对照组(P<0.05),研究组的总有效率89.80%高于对照组但差异无显著性(P>0.05)。结论 MP感染引发小儿哮喘采用大阿奇霉素联合β2受体兴奋剂和糖皮质激素治疗对于缓解患儿的临床症状、提高治疗效果具有积极的作用。Objectine To explore the efficacy of macrolide（azithromycin）combined with bronchodilator and corticosteroids in treatment of pediatric patients with Mycoplasma pneumonia（MP）infection complicated with asthma. Methods A total of 98 pediatric cases of MP infection complicated with asthma during July 2011 to April 2014 were allocated in study group and control group,each group with 49 cases. Patients in study group were treated by using azithromycin combined with β 2 receptor agonists and glucocorticosteroids,and patients in control group were treated by azithromycin combined with β2 receptor stimulant. The efficacy had been compared between these two groups of children. Results The＆amp;nbsp;rate of fever,pulmonary rales and incidence of wheezing at 3 days after treatment in study group were significantly lower than those in patients of control group（ P ﹤ 0. 05）. The duration for disappearance of coughing and hospitalization time were significantly shorter than those of control group,and the maximum peak velocity in study group was significantly higher than that of control group,the duration for recurrence in study group was significantly longer than that of control group,and their difference was statistically significant（ P ﹤ 0. 05）. Relapse rate and positive rate of MP - IgM antibody in study group were higher than those of control group,but the difference was not statistically significant（ P ﹥ 0. 05）. The dis-tribution of efficacy in study group was significantly better than that of control group（ P ﹤ 0. 05）,and the total efficiency in study group was 89. 80% it was higher than that of control group but the difference was not significant（ P ﹥ 0. 05）. Conclusion The treatment of MP infection in-duced asthma in pediatric patients by azithromycin combined with β2 receptor agonists and corticosteroids can relieve the clinical symptoms,and actively promote the efficacy of treatment.

关 键 词：肺炎支原体 哮喘 大环内脂类 阿奇霉素 糖皮质激素 

分 类 号：R725.6[医药卫生—儿科]