阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染的疗效、安全性及对炎性因子水平的影响  

Efficacy,safety and effect of azithromycin sequential therapy on inflammatory cytokines in preschool children with pneumonia mycoplasma infection

作　　者：高群英[1] 袁纯[1] 丁国标[1] 

机构地区：[1]江西省九江市妇幼保健院,江西九江332000

出　　处：《现代中西医结合杂志》2015年第32期3549-3551,3555,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染的疗效、安全性及对炎性因子水平的影响。方法选择学龄前支原体肺炎患儿120例,随机分为序贯1组、序贯2组,每组60例。2组均给予补液、退热、止咳、祛痰等常规治疗,在此基础上,序贯1组给予阿奇霉素静脉滴注3 d,停用4 d后改为阿奇霉素干混悬剂口服7 d;序贯2组给予阿奇霉素静脉滴注5 d,停用4 d后改为阿奇霉素干混悬剂口服5 d。观察2组疗效、不良反应,治疗前及治疗后3 d、7 d、14 d血清IL-6、IL-10及CRP水平的变化。结果 2组治疗14 d有效率比较差异无统计学意义;2组治疗后退热、啰音消失、X射线片恢复正常时间及咳嗽控制时间比较差异均无统计学意义(P均>0.05);序贯1组不良反应发生率明显低于序贯2组(P<0.05);2组治疗后各时间段血清IL-6、IL-10及CRP水平与治疗前比较差异均有统计学意义(P均<0.05),治疗3 d后2组血清IL-6、IL-10及CRP水平均明显下降,治疗14 d各指标达正常水平,2组间比较差异均无统计学意义。结论阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染疗效显著,可有效降低血清炎性因子水平,且静脉用药3d的序贯疗法安全性更高。Objective It is to explore the efficacy, safety and effect of azithromycin sequential therapy on inflammatory cy-tokines in preschool children with pneumonia mycoplasma infection. Methods 180 cases of preschool children with mycoplasma pneumonia were selected and were divided into sequential group I , sequential group Ⅱ randomly, with 60 cases in each group. Based on the basic therapy of fever, cough, expectorant, rehydration, the patients of sequential group I were given intravenous infusion of azithromyc for 3 d, and used azithromycin for suspension oral treatment 7 d with 4 d after discontinuation; the patients of sequential group Ⅱ were given intravenous infusion of azithromyc for 5 d, and used azithromycin for sus- pension oral treatment 5 d with 4 d after discontinuation. The curative effect, adverse reactions and the change of serum levels of IL -6, IL - 10 and CRP before treatment and 3 d,7 d, 14 d after treatment were observed in both groups. Results There was no significant difference in 14 d efficiency, defervesce, rales disappeared, X - ray sheet returned to normal time and cough control time between the two groups （ P 〉 0.05 ）. The adverse reaction rates of sequential group [ was significantly lower than that of sequential group I1 （ P 〈 0.05 ）. After treatment serum there were significant differences in IL - 6, IL - 10 and CRP between the two groups at each time stage （ P all 〈 0.05 ） , the levels of IL - 6, IL - 10 and CRP were decreased obviously after treatment for 3 days in both groups, and the indexes reach normal level after treatment for 14 days, there was no signif- icant differences between the two groups. Conclusion The efficacy of Azithromyein sequential therapy in the treatment of My- coplasma pneumoniae infection in preschool children is significant, which can effectively improve the level of serum inflammatory cytokines, with a higher safety when using 3 d intravenous drug sequential therapy.

关 键 词：阿奇霉素 序贯疗法 肺炎支原体感染 安全性 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统]