阿奇霉素联合甲强龙治疗支原体肺炎肺实变患儿的随机对照临床试验  

A randomized controlled clinical trial of azithromycin combined with methylprednisolone in treating pulmonary consolidation from mycoplasma pneumonia

作　　者：张文喜[1] 刘东红[2] 赵蓓[1] 赵佳佳[1] 蔡俏[1] 高未 蔡奔奔 ZHANG Wenxi;LIU Donghong;ZHAO Bei;ZHAO Jiajia;CAI Qiao;GAO Wei;CAI Benben(Department of Pediatrics;Department of Clinical Lab,Taizhou First People＇s Hospital,Taizhou 318020,Zhejiang,China)

机构地区：[1]台州市第一人民医院儿科 [2]台州市第一人民医院检验科

出　　处：《中国临床药理学与治疗学》2018年第9期1052-1055,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：浙江省医药卫生科技计划项目(2015KYB139);浙江省台州市科技局课题(15yw05)

摘　　要：目的:探讨阿奇霉素联合甲强龙治疗支原体肺炎肺实变患儿的临床效果。方法:82例支原体肺炎肺实变患儿按随机数表法分为对照组和试验组,每组41例。对照组在常规治疗基础上联合阿奇霉素治疗,每次10 mg·kg-1·d-1,静脉滴注,qd,持续治疗5 d。试验组在对照组基础上联合甲强龙治疗,每次1 mg/kg,静脉滴注,q12h,持续治疗5 d。比较两组临床疗效、临床症状缓解时间、血清指标和不良反应发生情况。结果:治疗后,试验组和对照组总有效率分别为90. 24%(37/41)和70. 73%(29/41),差异有统计学意义(P <0. 05)。试验组临床症状缓解时间均少于对照组,差异有统计学意义(P <0. 05)。试验组和对照组C反应蛋白(CRP)分别为(14. 73±1. 84)和(19. 64±2. 63) mg/L,IL-6分别为(50. 49±6. 05)和(69. 21±7. 42) mg/L,血沉(ESR)分别为(27. 47±3. 30)和(31. 11±4. 73) mm/h,差异有统计学意义(P <0. 05)。两组均有皮疹瘙痒、恶心呕吐发生,试验组和对照组不良反应发生率分别为26. 83%(11/41)和12. 19%(5/41),差异无统计学意义(P> 0. 05)。结论:阿奇霉素联合甲强龙治疗支原体肺炎肺实变患儿的疗效优于阿奇霉素,能够有效缓解临床症状,提高临床效果,且未明显增加药物不良反应发生率。AIM： To explore the clinical effect of azithromycin combined with methylprednisolone in treating pulmonary consolidation from mycoplasma pneumonia. METHODS： Eighty-two patients with pulmonary consolidation from mycoplasma pneumo- nia were divided into control group and treatment group according to random number table method. The control group received routine treatment com- bined with azithromycin of 10 mg· kg^-1· d^-1 （ intra- venous drip, qd） and for a continuous treatment of 5 days. The treatment group received extra methylpred- nisolone of 1 mg/kg （intravenous drip,q12h） for a continuous treatment of 5 days on the basis of the control group. The clinical efficacy, clinical symptom relief time, the serum index and the adverse reaction occurred between two groups were compared. RESULTS：After treatment, the total effective rate in the treatment group and the control group was 90.24% （37/41 ） and 70.73 % （29/41 ）, respectively （P 〈 0.05 ）. The clinical symptom relief time in the treatment group was shorter than that of the con-trol group （P 〈 0.05 ）. The C reactive protein （CRP） in the treatment group and the control group was （14.73 ±1.84） and （19.64 ±2.63）mg/L,in- terleukin-6 （IL-6） was （50.49 ± 6.05） and （69.21 ± 7.42 ） mg/L, erythrocyte sedimentation rate （ESR） was （27.47 ±3.30） and （31.11 ± 4.73 ） mm/h, respectively （P 〈 0.05 ）. Both groups had rashes and itching, nausea and vomiting, and the adverse reaction rate in the treatment group and the control group was 26.83% （ 11/41 ） and 12.19% （5/41）, respectively （ P 〉 0.05 ）. CONCLU- SION：The combined treatment of azithromycin plus methylprednisolone for pulmonary consolidation from mycoplasma pneumonia is better than azithromycin alone. It can effectively relieve clinical symptoms and improve clinical effect with no significant in- crease in the incidence of adverse drug reactions.

关 键 词：支原体肺炎肺实变 阿奇霉素 甲强龙 随机对照 

分 类 号：R563.1[医药卫生—呼吸系统]