难治性支原体肺炎患儿经阿奇霉素治疗的效果及风险因素分析  

Analysis of the Effect and Risk Factors of Azithromycin Therapy in Children with Refractory Mycoplasma Pneumonia

作　　者：黄剑锋 HUANG Jianfeng(Pharmacy of Yangli Township Health Center,Minhou County,Fuzhou 350105,China)

机构地区：[1]福州市闽侯县洋里乡卫生院药房,福州350105

出　　处：《中国医药指南》2024年第28期33-36,共4页Guide of China Medicine

摘　　要：目的探究难治性支原体肺炎(RMPP)患儿经阿奇霉素治疗的效果及风险因素分析。方法按回顾性分析纳入2021年12月至2023年12月我院收治的85例RMPP患儿作为研究对象,所有患儿均接受阿奇霉素治疗,根据患儿临床疗效分为有效组和无效组。对比两组临床资料和疾病相关特征,选择Logistic回归分析有差异的项目,得出影响患者临床疗效的因素。结果有效组患儿共58例(68.24%),无效组患儿共27例(31.76%)。两组患儿发热持续时间、乳酸脱氢酶(LDH)、C反应蛋白(CRP)、中性粒细胞比例差异有统计学意义(P<0.05)。经Logistic回归方程分析发现上述指标均是导致患儿治疗无效的影响因素,AUC值范围为0.660~0.839,发热持续时间(灵敏度0.630,特异度0.690)、LDH(灵敏度0.852,特异度0.586)、CRP(灵敏度0.778,特异度0.828)、中性粒细胞比例(灵敏度0.630,特异度0.690)预测患儿治疗无效的价值较高。结论RMPP患儿经阿奇霉素治疗后无效的影响因素较多,包括发热持续时间、LDH、CRP、中性粒细胞比例,临床需引起重视,尽早制订对应措施进行干预。Objective To investigate the effect of refractory mycoplasma pneumonia(RMPP)children treated with azithromycin and risk factor analysis.Methods A total of 85 cases of children with RMPP admitted to our hospital from December 2021 to December 2023 were included in the study according to retrospective analysis,and all the children were treated with azithromycin,and they were divided into effective and ineffective groups according to their clinical efficacy.Comparing the clinical data and disease-related characteristics of the two groups,Logistic regression was chosen to analyze the different items,and the factors affecting the clinical efficacy of the patients were derived.Results There were 58 children(68.24%)in the effective group and 27 children(31.76%)in the ineffective group.The differences in fever duration,lactate dehydrogenase(LDH),C-reactive protein(CRP),and neutrophil ratio between the two groups were statistically significant(P<0.05).The Logistic regression equation analysis revealed that all of the above indexes were influential factors leading to ineffective treatment of the children,with AUC values ranging from 0.660 to 0.839,fever duration(sensitivity 0.630,specificity 0.690),LDH(sensitivity 0.852,specificity 0.586),CRP(sensitivity 0.778,specificity 0.828),neutrophil proportion(sensitivity 0.778,specificity 0.828),and neutrophil percentage(sensitivity 0.778,specificity 0.828).granulocyte ratio(sensitivity 0.630,specificity 0.690)were of high value in predicting treatment failure in children.Conclusions There are many factors affecting the ineffectiveness of azithromycin treatment in children with RMPP,including fever duration,LDH,CRP,and neutrophil ratio,which need to be emphasized in the clinic,and corresponding measures should be formulated as early as possible to intervene.

关 键 词：难治性支原体肺炎 阿奇霉素 乳酸脱氢酶 C反应蛋白 中性粒细胞 

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