甲泼尼龙联合阿奇霉素对难治性支原体肺炎患儿淋巴细胞亚群及血浆凝血酶调节蛋白、D-二聚体的影响  

Effect of methylprednisolone combined with azithromycin on lymphocyte subsets,plasma thrombomodulin,and D-dimer in children with refractory Mycoplasma pneumoniae pneumonia

作　　者：李晓侠 马健 

机构地区：[1]徐州市儿童医院,江苏徐州221000 [2]彭城监狱医院,江苏徐州221003

出　　处：《中国妇幼保健》2017年第23期5914-5917,共4页Maternal and Child Health Care of China

摘　　要：目的探讨甲泼尼龙联合阿奇霉素治疗难治性支原体肺炎(RMPP)患儿的临床效果及对患儿淋巴细胞亚群、血浆凝血酶调节蛋白、D-二聚体等的影响。方法采用前瞻性研究,将2014-2015年来徐州市儿童医院就诊的RMPP患儿按照数字表法分为对照组(阿奇霉素)及观察组(阿奇霉素+甲泼尼龙),每组74例,比较两组患儿临床治疗效果及患儿淋巴细胞亚群、血浆凝血酶调节蛋白、D-二聚体、炎性因子表达量的差异,并对患儿住院时间、药物不良反应等进行比较。结果经治疗,观察组与对照组患儿在临床治疗总有效(93.7%vs.81.1%)、CD_3^+T细胞[(72.43±9.61)%vs.(67.33±9.52)%]、CD_4^+T细胞[(37.73±7.42)%vs.(30.74±8.11)%]、CD_8^+T细胞[(25.62±6.54)%vs.(23.44±6.23)%]水平比较,差异均具有统计学意义(均P<0.05);观察组与对照组患儿血浆凝血酶调节蛋白[(9.37±3.35)ng/ml vs.(16.93±4.18)ng/ml]、D-二聚体[(0.07±0.01)mg/L vs.(0.25±0.08)mg/L]水平比较,差异均具有统计学意义(均P<0.05);观察组患儿白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、C-反应蛋白(CRP)炎性因子表达水平低于对照组,且观察组住院时间、病情反复次数及持续时间均少于对照组,差异均具有统计学意义(均P<0.05),但两组患儿药物不良反应率比较,差异无统计学意义(P>0.05)。结论甲泼尼龙联合阿奇霉素可有效提高RMPP治疗效果,改善患儿免疫功能及降低血凝症状。Objective To explore the clinical effect of methylprednisolone combined with azithromycin in treatment of children with re- fractory Myeoplasmapneumoniae pneumonia （RMPP） and the influence on lymphocyte subsets, plasma thrombomodulin, and D-dimer. Methods A prospective study was conducted, the children with RMPP were selected from the hospital from 2014 to 2015, then they were divided into control group （azithromycin） and observation group （azithromycin＋ methy]prednisolone） according to random number table, 74 children in each group. The clinical effects, the levels of lymphocyte subsets, plasma thrombomodulin, D-dimer, and inflammatory factors, hospitalization time, drug adverse reactions in the two groups were compared. Results After treatment, the total effective rates, the levels of CD3 ＋ T cells, C D4＋ T cells, and C D8＋T cells in observation group and control group were 93.7% and 81.1% , （72.43±9.61）% and （67.33±9. 52）% , （37.73±7.42）% and （30. 74±8. 11 ）%, （25.62±6. 54）% and （23.44±6. 23）%, respectively, there were sta- tistically significant differenees between the two groups （ all P〈0. 05 ）.The levels of plasma thrombomodulin and D-direct in observation group and control group were （9.37±3.35） ng/ml and （ 16. 93±4. 18） ng/ml, （0. 07±0. 01 ） mg/L and （0. 25±0. 08） mg/L, respective- ly, there were statistically significant differences between the two groups （all P 〈 0. 05 ） . The expression levels of interleukin-6, interleukin-10, and C-reactive protein in observation group were lower than those in control group, while hospitalization time, the number of repeated episodes, and duration time in observation group were less than those in control group, there were statistically significant differences between the two groups （ all P〈0. 05 ） ; there was no statistically significant difference in the incidence rate of drug adverse reactions between the two groups （ P〉 0. 05 ） . Conclusion Methylprednisolone combined with

关 键 词：甲泼尼龙 阿奇霉素 难治性支原体肺炎 免疫功能 凝血 

分 类 号：R725.6[医药卫生—儿科]