甲泼尼龙治疗儿童难治性肺炎支原体肺炎的临床分析  

Clinical analysis of methylprednisolone in the treatment of children refractory mycoplasma pneumoniae pneumonia

作　　者：余洁明[1] 王杏[1] 吴春远[1] 刘海英[1] 刘瑜[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院儿科,518028

出　　处：《中国实用医药》2017年第15期7-9,共3页China Practical Medicine

摘　　要：目的探讨甲泼尼龙在儿童难治性肺炎支原体肺炎(RMPP)中的临床应用和疗效。方法 70例RMPP患儿,随机分为对照组和观察组,各35例。两组均采用红霉素抗感染治疗,体温稳定48 h后改阿奇霉素口服序贯治疗,观察组在抗感染的基础上同时使用甲泼尼龙2 mg/(kg·d)静脉滴注治疗。观察两组患儿体温恢复正常时间、咳嗽缓解时间和肺部啰音消失时间,对比治疗前后两组患儿中性粒细胞比值、C反应蛋白和血清铁蛋白改善情况。结果观察组患儿体温恢复正常时间、咳嗽消失时间和肺部啰音消失时间分别为(3.7±1.7)、(5.7±2.1)、(6.6±1.8)d,均短于对照组的(5.8±1.9)、(7.1±2.2)、(7.8±2.1)d,差异具有统计学意义(P<0.05)。治疗后,两组患儿中性粒细胞比值、C反应蛋白、血清铁蛋白等炎症相关指标均较治疗前改善,且观察组患儿改善程度优于对照组,差异具有统计学意义(P<0.05)。结论对于RMPP患儿,在使用大环内酯类抗生素的基础上同时给予甲泼尼龙,能显著缩短症状和体征持续时间,改善炎性指标,加快患儿恢复。Objective To investigate clinical application and curative effect by methylprednisolone in the treatment of children refractory mycoplasma pneumoniae pneumonia （RMPP）. Methods A total of 70 RMPP children patients were randomly divided into control group and observation group, with 35 cases in each group. Both groups received erythromycin for anti-infection treatment, followed by oral administration of azithromycin as sequential therapy after 48 h with stable body temperature. The observation group received additional methylprednisolone by 2 mg/（kg·d） through intravenous drip for treatment. Observation was made on body temperature recovery time, cough remission time and lung rale disappearance time in the two groups. Comparison was made on improvements of neutrophil ratio, C-reactive protein and serum ferritin between the two groups before and after treatment. Results The observation group had body temperature recovery time, cough remission time and lung rale disappearance time respectively as （3.7 ± 1.7）, （5.7 ± 2.1） and （6.6 ± 1.8）d, which were all shorter than （5.8 ± 1.9）, （7.1 ± 2.2） and （7.8 ± 2.1） d in the control group, and their difference had statistical significance （P〈0.05）. After treatment, both groups had improvements of neutrophil ratio, C-reactive protein and serum ferritin, and the observation group had better improvement degree than the control group, and the difference had statistical significance （P〈0.05）. Conclusion Implement of methylprednisolone in addition to macrolides antibiotics for RMPP children can remarkably shorten duration of symptoms and vital signs, improve inflammatory indicators and accelerate children rehabilitation.

关 键 词：难治性肺炎支原体肺炎 儿童 甲泼尼龙 

分 类 号：R725.6[医药卫生—儿科]