糖皮质激素联合阿奇霉素对迁延性小儿支原体肺炎血清炎症因子及临床改善情况的研究  

The study on the effect of glucocorticoid combined with azithromycin on serum inflammatory factors and clinical improvement of persistent mycoplasma pneumonia in children

作　　者：韩聪莉 党媛媛 田庆玲[1] 宋鹏[1] 冯雪[1] 杨硕[1] HAN Congli;DANG Yuanyuan;TIAN Qingling;SONG Peng;FENG Xue;YANG Shuo(Tangshan Maternal and Child Health Hospital, Tangshan Hebei 063000, China)

机构地区：[1]唐山市妇幼保健院,河北唐山063000

出　　处：《新疆医科大学学报》2020年第7期901-904,共4页Journal of Xinjiang Medical University

基　　金：河北省卫生和计划生育委员会医学重点课题计划项目(20181333)。

摘　　要：目的研究糖皮质激素联合阿奇霉素对迁延性小儿支原体肺炎血清炎症因子及临床改善情况。方法随机选取2017年6月-2019年6月唐山市妇幼保健院收治的98例迁延性小儿支原体肺炎患者,按随机数字表分为对照组和观察组,每组各49例。对照组采用阿奇霉素治疗,观察组采用地塞米松联合阿奇霉素治疗,连续治疗1周,检测患儿的炎症因子水平,测试患儿的肺功能指标,评价临床疗效并记录不良反应发生情况。结果观察组治疗有效率为93.38%(46/49),明显高于对照组治疗有效率85.71%(42/49),差异有统计学意义(P<0.05)。治疗后,两组患者的白细胞介素-8(IL-8)、C反应蛋白(CRP)、降钙素原(PCT)及基质金属蛋白酶(MMP-9)水平均明显降低,但观察组明显低于对照组(P<0.05)。观察组呼吸频率(RR)低于对照组,每公斤体质量潮气量(Vt/kg)、达峰容积比(VPTFF/tE)及达峰时间比(TPTFF/tE)高于对照组,差异有统计学意义(P<0.05)。观察组的退热时间、止咳时间、住院时间及湿啰音消失明显短于对照组,差异有统计学意义(P<0.05)。两组患儿的不良反应发生率差异无统计学意义(P>0.05)。结论采用糖皮质激素联合阿奇霉素治疗迁延性小儿支原体肺炎,能明显改善患儿的炎症因子及肺功能指标,临床症状消失时间缩短,并可提高治疗有效率。Objective To study the effect of glucocorticoid combined with azithromycin on serum inflammatory factors and clinical improvement in children with persistent mycoplasma pneumonia.Methods From June 2017 to June 2019,98 children with mycoplasma pneumoniae were randomly selected from Tangshan maternal and child health hospital,and divided into control group and observation group according to the random number table,with 49 cases in each group.The control group was treated with azithromycin,and the observation group was treated with dexamethasone and azithromycin for one week.The content of inflammatory factors,lung function index,clinical effect and adverse reactions were measured.Results The effective rate of the observation group was 93.38%(46/49),which was significantly higher than that of the control group(85.71%).After treatment,the levels of IL-8,CRP,PCT and MMP-9 in the two groups were significantly lower than those in the control group(P<0.05).The respiratory rate(RR)of the observation group was lower than that of the control group,and the tidal volume per kilogram body weight,peak volume ratio and peak time ratio of the observation group were higher than those of the control group(P<0.05).The antipyretic time,antitussive time,hospitalization time and the disappearance of moist rales in the observation group were significantly shorter than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Glucocorticoid combined with azithromycin can improve the index of inflammatory factors and pulmonary function of children with mycoplasma pneumoniae,shorten the time of clinical symptoms disappear,and improve the efficiency of treatment,which is worthy of clinical reference.

关 键 词：糖皮质激素 阿奇霉素 迁延性 支原体肺炎 血清炎症因子 

分 类 号：R725.6[医药卫生—儿科]