糖皮质激素辅助治疗儿童重症肺炎支原体肺炎的临床研究  

Clinical trial of glucocorticoid on adjuvant therapy of severe mycoplasma pneumoniae pneumonia in children

作　　者：孙建华[1] 赵雨芳[2] 叶君红 SUN Jian-hua;ZHAO Yu-fang;YE Jun-hong(Department of Pediatrics,Huzhou Hospital of Traditional Chinese Medicine,Huzhou 313000,Zhejiang Province,China;Department of Pediatrics,Jinhua Central Hospital,Jinhua 321000,Zhejiang Province,China;Department of Pediatrics,Changxing County Women’s Hospital,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市中医院儿科,浙江湖州313000 [2]金华市中心医院儿科,浙江金华321000 [3]长兴县妇保院儿科,浙江湖州313000

出　　处：《中国临床药理学杂志》2021年第7期795-797,801,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察糖皮质激素的合理使用对儿童重症肺炎支原体肺炎(SMPP)的辅助治疗效果。方法将80例患儿依据随机数表法分为对照组40例与试验组40例。对照组用阿奇霉素序贯治疗:第1~7天,10 mg·kg^(-1)阿奇霉素注射液+葡萄糖注射液250 mL,每天1次,静脉滴注;第8~15天,10 mg·kg^(-1)阿奇霉素分散片,每天1次,口服。试验组在对照组基础上给予糖皮质激素治疗:第1~3天,1.5 mg·kg^(-1)甲泼尼龙琥珀酸钠,每天1次,静脉滴注;第4~15天,1.0 mg·kg^(-1)甲泼尼龙琥珀酸钠,每天1次,静脉滴注。2组治疗时间均为15 d。比较2组患者的超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、症状及体征持续时间、治疗效果和药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为100.00%(40例/40例)和85.00%(34例/40例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的hs-CRP分别为(9.87±2.72)和(12.25±3.81)mg·L^(-1),IL-6分别为(5.13±0.72)和(6.62±0.81)pg·mL^(-1),TNF-α分别为(4.20±1.32)和(4.71±1.77)ng·L^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组的发热持续时间分别为(2.01±0.47)和(3.34±0.62)d,咳嗽持续时间分别为(3.20±0.61)和(5.24±1.22)d,肺部湿啰音持续时间分别为(5.37±1.72)和(7.53±1.91)d,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为20.00%和17.50%,差异无统计学意义(P>0.05)。结论合理使用糖皮质激素在SMPP患儿治疗过程中,有助于提升治疗效果,改善血清因子指标,缩短症状和体征的持续时间。Objective To observe the effect of the rational use of corticosteroids on the adjuvant treatment of severe mycoplasma pneumoniae pneumonia(SMPP)in children.Methods According to the random number method,80 children were divided into control group(n=40)and an treatment group(n=40).Control group was treated with azithromycin sequentially:d1-d7,10 mg·kg^(-1) azithromycin injection+glucose injection 250 mL,qd,intravenous drip;on d8-d15,10 mg·kg^(-1) azithromycin dispersible tablets,qd,orally.Treatment group was treated with glucocorticoids on the basis of control group:d1-d3,1.5 mg·kg^(-1) methylprednisolone sodium succinate,qd,intravenous drip;on d4-d15,1.0 mg·kg^(-1) methylprednisolone sodium succinate,qd,intravenous drip.The treatment time for both groups was 15 d.The hypersensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),duration of symptoms and signs,treatment effects,and adverse drug reactions in two gorups were compared.Results After treatment,the total effective rates in treatment group and control group were 100.00%(40 cases/40 cases)and 85.00%(34 cases/40 cases),the difference was statistically significant(P<0.05).After treatment,the hs-CRP in treatment group and control group were(9.87±2.72)and(12.25±3.81)mg·L^(-1),IL-6 were(5.13±0.72)and(6.62±0.81)pg·mL^(-1),TNF-αwere(4.20±1.32)and(4.71±1.77)ng·L^(-1),all with significant differences(all P<0.05).The duration of fever in treatment group and control group were(2.01±0.47)and(3.34±0.62)d,the duration of cough were(3.20±0.61)and(5.24±1.22)d,the duration of rales in lungs were(5.37±1.72)and(7.53±1.91)d,the difference were all statistically significant(all P<0.05).The incidence of adverse drug reactions in treatment group and control group were 20.00%and 17.50%,without significant difference(P>0.05).Conclusion Reasonable use of glucocorticoids in the treatment of SMPP children help to improve the treatment effect,improve serum factor indicators,shorten the duration of symptoms and signs.

关 键 词：糖皮质激素 肺炎支原体肺炎 阿奇霉素 甲泼尼龙 

分 类 号：R974[医药卫生—药品]