不同剂量糖皮质激素联合阿奇霉素治疗小儿重症肺炎支原体肺炎的效果  

Effect of Different Doses of Glucocorticoids Combined with Azithromycin in the Treatment of Severe Mycoplasma Pneumonia in Children

作　　者：谢俊锋[1] 卢成瑜[2] XIE Junfeng;LU Chengyu(Department of Pediatrics,the Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518000,China;Department of Pediatrics,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]中山大学附属第七医院儿科,深圳518000 [2]广州医科大学附属第一医院儿科,广州510120

出　　处：《中国医药指南》2024年第23期10-13,共4页Guide of China Medicine

基　　金：广州市科技计划项目,市校(院)联合资助项目(202201020419)。

摘　　要：目的探讨不同剂量糖皮质激素联合阿奇霉素治疗小儿重症肺炎支原体肺炎(SMPP)的效果。方法回顾性分析2021年1月至2023年12月在我院儿科治疗的SMPP病例,这些患儿均使用糖皮质激素联合阿奇霉素治疗。根据糖皮质激素使用剂量不同分为3组,每组22例患儿(共66例):A组使用低剂量1 mg/(kg·d)糖皮质激素治疗,B组使用中剂量2 mg/(kg·d)糖皮质激素治疗,C组使用高剂量≥3 mg/(kg·d)糖皮质激素治疗,疗程为5~7 d。对比3组的临床疗效、症状消失时间、住院时间、炎性因子变化的差异。结果C组治疗有效率为95.45%,高于A组的68.18%及B组的72.73%(P<0.05);C组退热时间、咳嗽缓解时间、肺部啰音消失时间、住院时间均短于A组和B组(均P<0.05);C组治疗后C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)低于A组和B组(P<0.05);3组均未发生内分泌系统、精神神经系统等严重不良反应,可存在少量胃肠道不适症状(P>0.05)。结论高剂量≥3 mg/(kg·d)糖皮质激素联合阿奇霉素治疗小儿SMPP的效果更好,能加快症状缓解速度,减轻炎性反应。Objective To observe the effect of different doses of glucocorticoids combined with azithromycin in the treatment of severe mycoplasma pneumoniae pneumonia(SMPP)in children.Methods The cases of SMPP treated in our department of pediatrics from January 2021 to December 2023 were analyzed retrospectively.All of these children were treated with glucocorticoid combined with azithromycin.According to different doses of glucocorticoids,they were divided into 3 groups,and 22 children(66 cases in total)were randomly selected from each group:group A was treated with low-dose 1 mg/(kg·d)glucocorticoids,group B was treated with medium-dose 2 mg/(kg·d)glucocorticoids,and group C was treated with high-dose≥3 mg/(kg·d)glucocorticoids for 5-7 days.The clinical efficacy,the time of symptom disappearance and the changes of inflammatory factors were compared among the three groups.Results The effective rate of group C was 95.45%,which was significantly higher than that of group A(68.18%)and group B(72.73%)(P<0.05).The time of fever remission,cough remission,lung rales disappearance and hospital stay in group C were shorter than those in groups A and B(P<0.05).After treatment,CRP,PCT and WBC in group C were lower than those in groups A and B(P<0.05).None of the three groups had serious adverse reactions,such as endocrine system and mental nervous system,and could have a small number of gastrointestinal discomfort symptoms,with comparable safety(P>0.05).Conclusions High-dose glucocorticoid combined with azithromycin has better effect in the treatment of SMPP in children,which can accelerate the speed of symptom relief and improve the anti-inflammatory effect.

关 键 词：小儿重症肺炎支原体肺炎 不同剂量糖皮质激素 阿奇霉素 炎症 

分 类 号：R563.1[医药卫生—呼吸系统] R725.6[医药卫生—内科学]