多西环素治疗儿童大环内酯类耐药支原体肺炎的疗效评价  

Evaluation of the curative effects of doxycycline in the treatment of pediatric macrolides-resistant mycoplasma pneumonia

作　　者：叶洪舟[1] 许小花[1] 李刚[1] 朱焰[1] 魏亚新[1] 管敏昌 

机构地区：[1]湖州师范学院附属第一医院儿科,浙江湖州313000 [2]台州恩泽医疗中心(集团)路桥医院,浙江台州318000

出　　处：《中国现代医生》2016年第21期121-124,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2015KYB446)

摘　　要：目的探讨多西环素对大环内酯类耐药支原体肺炎的临床疗效。方法选取2015年4～9月在湖州师范学院附属第一医院就诊的72例8周岁以上的对大环内酯类耐药的肺炎支原体肺炎患儿,其中单用阿奇霉素口服21例,单用多西环素口服23例,阿奇霉素口服联合甲强龙注射28例,分析三组患儿的年龄、性别构成比、并发症、72 h内的体温变化及药物不良反应的差异。结果三组患儿在年龄、性别和并发症方面无显著差异。72 h内的体温改善情况,多西环素组优于阿奇霉素组（P〈0.01）,阿奇霉素联合甲强龙组优于阿奇霉素组（P〈0.01）,多西环素组和阿奇霉素联合甲强龙组间无显著差异（P〉0.05）。同时三组患儿均无明显不良反应。结论对于8周岁以上大环内酯类耐药的肺炎支原体肺炎患儿,多西环素在患儿的体温改善方面体现出良好的疗效,且不良反应少。Objective To explore the clinical curative effects of doxycycline in the treatment of macrolides-resistant mycoplasma pneumonia. Methods A total of 72 pediatric patients with macrolides-resistant mycoplasma pneumonia who were over 8 years old and were admitted to the First Affiliated Hospital of Huzhou Teachers College from April to September 2015 were selected. Among them, 21 patients were orally given azithromycin alone, 23 patients were given doxycycline alone, and 28 patients were orally given azithromycin combined with the injection of methylprednisolone.The differences of composition ratio of age and gender, complications, 72-hour temperature change and drug adverse reactions were analyzed in the three groups of pediatric patients. Results There were no significant differences in the age, gender and complications in the three groups of patients. For the improvement of 72-hour body temperature, the doxycycline group was better than that in the azithromycin group（P〈0.01）, and azithromycin combined with methylprednisolone group was better than that in the azithromycin group（P〈0.01）. There was no significant difference between doxycycline group and azithromycin combined with methylprednisolone group（P〉0.05）. There was no adverse reaction in all the three groups of patients. Conclusion For the children patients over 8 years old with macrolides-resistant mycoplasma pneumonia, the curative effect of doxycycline is better in the improvement of body temperature, and the adverse reactions are few.

关 键 词：多西环素 耐药 肺炎支原体 大环内酯 

分 类 号：R725.6[医药卫生—儿科]