阿奇霉素联合丙种球蛋白治疗难治性支原体肺炎临床效果评价  

Clinical evaluation of azithromycin combined with gamma globulin in the treatment of refractory mycoplasmal pneumonia

作　　者：邹国新[1] 张慧丽[1] 朱少合 姚家瑜[1] ZOU Guoxin;ZHANG Huili;ZHU Shaohe;YAO Jiayu(Department of General Pediatrics,Yingde People’s Hospital in Guangdong Province,Yingde 513000,China)

机构地区：[1]广东省英德市人民医院普儿科

出　　处：《中国现代医生》2019年第33期63-66,共4页China Modern Doctor

基　　金：广东省清远市社会发展领域自筹经费科技计划项目(170809221900155)

摘　　要：目的探讨阿奇霉素联合丙种球蛋白治疗难治性支原体肺炎患儿的临床效果及不良反应。方法选取2017年1月~2019年4月90例儿童难治性支原体肺炎将根据随机数字表法分组。按照1∶1∶1分为A、B、C三组。A组予以静脉滴注阿奇霉素10 mg/(kg·d)+甲强龙2 mg/(kg·d),治疗3 d。B组予以静脉滴注阿奇霉素10 mg/(kg·d)+丙种球蛋白400 mg/(kg·d),治疗3 d。C组仅予以静脉滴注阿奇霉素。观察4 d,并记录每组患儿的临床症状、实验室指标变化及副作用。结果 B组儿童难治性支原体肺炎治疗效果高于A组和C组(P<0.05);B组肺部阴影消失时间、咳嗽消失时间、体温恢复时间、肺部啰音消失时间均优于A组和C组(P<0.05);治疗后B组血清学炎症指标优于A组和C组(P<0.05)。而上述指标的对比中,A组均优于C组(P<0.05)。三组不良反应无明显差异(P>0.05)。结论儿童难治性支原体肺炎临床治疗应用阿奇霉素联合丙种球蛋白效果确切,明显优于联合甲强龙及单用阿奇霉素,可有效改善血清学炎症指标及预后,无明显不良反应,值得推广应用。Objective To investigate the clinical effects and adverse reactions of azithromycin combined with gamma globulin in the treatment of children with refractory mycoplasmal pneumonia.Methods According to the random number table method,90 children with refractory mycoplasmal pneumonia in children from January 2017 to April 2019 were divided into group A,B,and C according to 1:1:1.The group A was given intravenous infusion of azithromycin10 mg/(kg·d)+methylprednisolone 2 mg/(kg·d)for 3 days.The group B was given intravenous infusion of azithromycin10 mg/(kg·d)+gamma globulin 400 mg/(kg·d)for 3 days.The group C was only given an intravenous infusion of azithromycin.The patients were observed for 4 days.And the clinical symptoms,laboratory indicators and side effects of each group were recorded.Results The treatment effect of refractory mycoplasmal pneumonia in children in group B was higher than that in group A and C(P<0.05).The disappearance time of lung shadow,the disappearance time of cough,the recovery time of body temperature and the disappearance time of pulmonary rale in group B were better than those in group A and group C(P<0.05).The serum inflammatory index of group B was better than that of group A and group C after treatment(P<0.05).The above indicators in group A were superior to those in group C(P<0.05).There were no significant differences in adverse reactions between the three groups(P>0.05).Conclusion The clinical application of azithromycin combined with gamma globulin in children with refractory mycoplasmal pneumonia has positive effect,which is superior to the combination of methylprednisolone and azithromycin alone.It can effectively improve the serum inflammatory index and prognosis,and has no obvious adverse reactions.It is worthy of popularization and application.

关 键 词：丙种球蛋白 甲强龙 儿童难治性支原体肺炎 应用效果 

分 类 号：R563.1[医药卫生—呼吸系统]