甲基强的松龙联合阿奇霉素对小儿支原体肺炎患者血清ECP水平、血气分析指标及肺泡通气量的影响  

Effects of methylprednisolone combined with azithromycin on serum eosinophil cationic protein level,blood gas analysis index,and alveolar ventilation in children with Mycoplasma pneumonia

作　　者：王丽芳 周润 WANG Li-fang;ZHOU Run(Department of Pediatrics,Shenxian Second People's Hospital,Shenxian 252423,Shandong,CHINA;Pediatric Intensive Care Unit,Liaocheng People's Hospital,Liaocheng 252000,Shandong,CHINA)

机构地区：[1]莘县第二人民医院儿科,山东莘县252423 [2]聊城市人民医院儿童重症监护室,山东聊城252000

出　　处：《海南医学》2020年第22期2931-2934,共4页Hainan Medical Journal

基　　金：山东省科学技术发展计划项目(编号;2012YD18026)。

摘　　要：目的研究甲基强的松龙联合阿奇霉素对小儿支原体肺炎患者血清嗜酸粒细胞阳离子蛋白(ECP)水平、血气分析指标及肺泡通气量的影响。方法选取2018年3月至2019年3月在莘县第二人民医院门诊治疗的130例小儿支原体肺炎患者作为研究对象,按照就诊顺序编号,并按完全随机数表法分为观察组和对照组,每组65例。两组患儿均在常规治疗的基础上静脉滴注阿奇霉素治疗,观察组在此基础上联合甲基强的松龙注射液静脉滴注治疗。两组患儿均治疗两个疗程。比较两组患儿治疗后的各项指标改善时间及不良反应发生情况,并观察治疗前后血气分析指标、血清总免疫球蛋白E(T-IgE)、ECP水平及肺功能情况。结果治疗后观察组患儿的退热、咳嗽好转、啰音消失时间明显短于对照组,差异均具有统计学意义(P<0.05);观察组患儿的不良反应发生率为9.23%,明显低于对照组的24.62%,差异具有统计学意义(P<0.05);与治疗前比较,治疗后两组患儿的动脉血氧分压(PO2)水平升高,二氧化碳分压(PCO2)水平降低,且治疗后观察组患儿的PO2水平升高更明显,PCO2水平降低更明显,差异均有统计学意义(P<0.05);与治疗前比较,治疗后两组患儿的血清T-IgE、ECP水平均降低,且观察组降低更明显,差异均有统计学意义(P<0.05);两组患儿的肺泡通气量占预计值百分比(VA%)、最大通气量(MVV%)治疗前后及组间比较差异均无统计学意义(P>0.05);与治疗前比较,治疗后两组患儿1 s量占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)、1 s率(FEV1/FVC%)、呼气峰值流速占预计值百分比(PEF%)均升高,且观察组升高更明显,差异均有统计学意义(P<0.05)。结论甲基强的松龙联合阿奇霉素治疗小儿支原体肺炎有效降低患儿的血清T-IgE、ECP、改善患儿的血气分析指标和肺功能,同时还可降低不良反应发生率。Objective To study the effects of methylprednisolone combined with azithromycin on serum eosinophil cationic protein(ECP),blood gas analysis,and alveolar ventilation in children with Mycoplasma pneumonia.Methods A total of 130 children with Mycoplasma pneumonia treated in Outpatient Department,Shenxian Second People's Hospital from March 2018 to March 2019 were selected as the research objects.The patients were numbered according to the sequence of visits and were divided into observation group and control group according to random number table method,with 65 patients in each group.On the basis of routine treatment,the control group was treated by intravenous drip of azithromycin,and the observation group was treated by intravenous drip of methylprednisolone combined with azithromycin,both for 2 courses.The improvement time of each indicator and the occurrence of adverse reactions after treatment were compared,and blood gas analysis indexes,serum total immunoglobulin E(T-IgE),ECP levels,and pulmonary function were observed before and after treatment.Results After treatment,the fever clearance time,the disappearance time of cough,and disappearance time of pulmonary rales in the observation group was significantly shorter than those in the control group(P<0.05).The difference in the incidence of adverse reactions between the control group and the observation group was statistically significant(24.62%vs 9.23%,P<0.05).Compared with before treatment,the level of arterial partial pressure of oxygen(PO2)increased and the level of partial pressure of carbon dioxide(PCO2)decreased in the two groups after treatment,and the level of PO2 increased more significantly and the level of PCO2 decreased more significantly in the observation group after treatment(P<0.05).Compared with before treatment,the levels of serum T-IgE and ECP in the two groups were decreased after treatment,and the decrease in the observation group was more obvious(P<0.05).There was no significant difference in the percentage of alveolus ventilation(VA%)an

关 键 词：甲基强的松龙 小儿支原体肺炎 血清 嗜酸粒细胞阳离子蛋白 血气分析 肺泡通气量 

分 类 号：R563.1[医药卫生—呼吸系统]