多西环素治疗阿奇霉素耐药儿童肺炎支原体肺炎的效果  

Effectiveness of doxycycline in the treatment of Mycoplasma pneumoniae pneumonia in azithromycin-resistant children

作　　者：崔雪琴 韩国宏 任启波 CUI Xue-qin;HAN Guo-hong;REN Qi-bo(East Branch of Anji County Third People's Hospital,Anji,Zhejiang 313301,China;不详)

机构地区：[1]安吉县第三人民医院东院儿科,浙江安吉313301 [2]湖州市吴兴区人民医院中医科,浙江湖州313008 [3]峨眉山市人民医院儿科,四川乐山614200

出　　处：《中华医院感染学杂志》2024年第20期3108-3112,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2021KY452)。

摘　　要：目的探究多西环素治疗阿奇霉素耐药儿童肺炎支原体肺炎的效果。方法收集2021年8月-2023年10月安吉县第三人民医院东院治疗的120例阿奇霉素耐药儿童肺炎支原体肺炎的病例资料,根据是否应用多西环素分为阿奇霉素组(n=65)和多西环素组(n=55);比较两组疗效、临床症状改善时间、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气峰值流量(PEF)]、炎症相关指标[C-反应蛋白(CRP)、乳酸脱氢酶(LDH)、D-二聚体(DD)]、肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)]及不良反应情况。结果多西环素组疗效优于阿奇霉素组(P<0.05);多西环素组退热时间、咳嗽缓解时间和肺部啰音消失时间分别为(2.15±0.65)、(4.59±0.71)和(5.36±0.84)d短于阿奇霉素组(P<0.05);治疗后,两组FVC、FEV_(1)和PEF较治疗前明显升高,CRP、LDH、DD、ALT和AST较治疗前降低,且多西环素组改善幅度高于阿奇霉素组(P<0.05);两组不良反应发生率差异无统计学意义(P=0.467)。结论多西环素治疗阿奇霉素耐药儿童肺炎支原体肺炎效果显著,可明显促进患儿肺功能与肝功能的恢复,降低炎症反应水平,且安全性良好。OBJECTIVE To investigate the efficacy of doxycycline in the treatment of Mycoplasma pneumoniae pneumonia(MPP)in azithromycin-resistant children.METHODS The clinical data of 120 children with azithromycin-resistant MPP treated in East Branch of Anji County Third People's Hospital between Aug.2021 and Oct.2023 were collected,and the patients were divided into azithromycin group(65 cases)and doxycycline group(55 cases)according whether doxycycline was applied or not.The curative effect,improvement times of clinical symptoms,lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),peak expiratory flow(PEF)],inflammatory indexes[C-reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer(DD)],liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and adverse reactions in the two groups were compared.RESULTS The curative effect was better in doxycycline group than azithromycin group(P<0.05).The pyretolysis time,relief time of cough and disappearance time of lung rale in doxycycline group were(2.15±0.65)d,(4.59±0.71)d and(5.36±0.84)d,shorter than those in azithromycin group(P<O.05).After treatment,FVC,FEV and PEF were significantly increased,while CRP,LDH,DD,ALT and AST were decreased in both groups than before treatment,and the improvement of the above indexes was better in doxycycline group than in the azithromycin group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.467).CONCLUSION Curative effect of doxycycline was significant in children with azithromycin-resistant MPP,which can significantly promote the recovery of lung function and liver function,and reduce inflammatory response,with a favorable safety profile.

关 键 词：肺炎支原体肺炎 阿奇霉素 耐药 多西环素 肝功能 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]