红霉素联合小剂量甲泼尼龙琥珀酸钠治疗儿童重症肺炎支原体肺炎的疗效  

Efficacy of erythromycin combined with methylprednisolone sodium succinate of reduced dosage in treatment of severe mycoplasma pneumonia in children

作　　者：刘平[1] 李艳玲 Liu Ping;Li Yan-ling(Department of Pediatrics,the First Affiliated Hospital,Anhui University of Science and Technology(Huainan First People's Hospital),Huainan 232001,China)

机构地区：[1]安徽理工大学第一附属医院(淮南市第一人民医院)儿科,淮南232001

出　　处：《中国药物应用与监测》2024年第5期609-613,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨儿童重症肺炎支原体肺炎应用红霉素联合小剂量甲泼尼龙琥珀酸钠的治疗效果。方法2023年1月至2024年5月于安徽理工大学第一附属医院儿科收治的儿童重症肺炎支原体肺炎共100例为试验对象,采用随机数字表法分成了两组,对照组患儿(50例)采取红霉素治疗,观察组患儿(50例)采取红霉素联合小剂量甲泼尼龙琥珀酸钠治疗,观察两组患儿临床疗效、退热时长、咳嗽咳痰缓解时长、肺部啰音消失时长、住院时长、治疗前后患儿C反应蛋白(CRP)、白细胞介素(IL-6)及肿瘤坏死因子α(TNF-α)等炎症因子指标变化及呼气流量峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))等肺功能指标变化、临床肺部感染评分(CIPS)变化及治疗期间的不良反应。结果总有效率方面,观察组患儿(98.00%)相较于对照组患儿(84.00%)更高,差异有统计学意义(χ^(2)=4.396,P<0.05);治疗后观察组患儿退热的时长、咳嗽咳痰缓解时长、肺部啰音消失的时长、住院时长[分别为(3.59±0.58)d、(5.18±0.95)d、(5.68±0.79)d、(15.19±2.00)d],均短于对照组患儿[(4.56±0.65)d、(7.72±1.00)d、(7.35±0.85)d、(17.45±2.12)d],差异有统计学意义(t=7.873、13.021、10.176、5.483,均P<0.001);治疗后观察组患儿CRP、IL-6、TNF-α浓度水平[分别为(12.59±2.00)mg·L^(-1)、(7.23±1.05)ng·L^(-1)、(1.32±0.20)mg·L^(-1)],均低于对照组患儿[(16.92±2.12)mg·L^(-1)、(10.45±1.63)ng·L^(-1)、(1.70±0.14)mg·L^(-1)],差异有统计学意义(t=10.505、11.743、11.006,均P<0.001);观察组患儿治疗后PEF、FVC、FEV_(1)水平分别为(198.54±7.95)L·min^(-1)、(1.79±0.30)L、(1.77±0.13)L,均高于对照组患儿(166.92±8.54)L·min^(-1)、(1.50±0.27)L、(1.45±0.15)L,差异有统计学意义(t=19.163、5.081、8.835,均P<0.001);观察组患儿治疗后CIPS评分为(3.23±0.59)分,低于对照组患儿(4.23±0.66)分,差异有统计学意义(t=7.988,P<0.001);观察组与对照组患儿�Objective To investigate the efficacy of erythromycin in combination with a minimal dose of methylprednisolone sodium succinate in treating severe mycoplasma pneumonia in children.Methods A total of 100 children with severe mycoplasma pneumonia admitted to the First Affiliated Hospital of Anhui University of Science and Technology from January 2023 to May 2024 were enrolled in this study and divided into the observation group and control group by random number method,with 50 in each group.The patients in the control group were treated with erythromycin alone while those in the observation group with erythromycin combined with methylprednisolone sodium succinate of reduced dosage.The clinical efficacy,time to defervescence,time to relief of cough and sputum,time to disappearance of lung rales,hospitalization duration,changes in levels of inflammatory factors such as C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)before and after treatment,as well as changes in levels of pulmonary function indicators including peak expiratory flow(PEF),forced vital capacity(FVC),and forced expiratory volume in one second(FEV_(1)),changes in Clinical Pulmonary Infection Score(CIPS)and incidence of adverse reactions were compared between the two groups.Results The overall effective rate in the observation group reached 98.00%,surpassing that of 84.00%in the control(χ^(2)=4.396,P<0.05).The time to defervescence,relief of cough and sputum,disappearance of lung rales,and hospitalization duration in the observation group were(3.59±0.58)d,(5.18±0.95)d,(5.68±0.79)d,and(15.19± 2.00) d, respectively, all of which were significantly shorter than those in the control ((4.56±0.65) d, (7.72±1.00) d, (7.35± 0.85) d, (17.45±2.12) d) (t=7.873, 13.021, 10.176, 5.483, all P<0.001). The levels of CRP, IL-6, and TNF-α in the observation group after treatment were (12.59±2.00) mg·L^(-1), (7.23±1.05) ng·L^(-1), and (1.32±0.20) mg·L^(-1), respectively, all of which were lower than those in the control ((16.

关 键 词：儿童重症 肺炎支原体肺炎 红霉素 甲泼尼龙琥珀酸钠 临床疗效 炎症反应 肺功能 临床肺部感染评分 不良反应 

分 类 号：R725.6[医药卫生—儿科] R969[医药卫生—临床医学]