多西环素与阿奇霉素治疗儿童支原体肺炎有效性、安全性及经济学比较  

Effectiveness,Safety and Economy Comparison of Doxycycline and Azithromycin in the Treatment of Pediatric Mycoplasmal Pneumonia

作　　者：李红桥[1,2] 夏雯 李兰 柯敏[1,2] 余向东 饶志威[3] 王雨来 LI Hongqiao;XIA Wen;LI Lan;KE Min;YU Xiangdong;RAO Zhiwei;WANG Yulai(Huangshi Central Hospital·Affiliated Hospital of Hubei Polytechnic University,Huangshi,Hubei,China 435000;Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention,Huangshi,Hubei,China 435000;Xianning Central Hospital·The First Affiliated Hospital of Hubei University of Science and Technology,Xianning,Hubei,China 437100)

机构地区：[1]湖北省黄石市中心医院·湖北理工学院附属医院,湖北黄石435000 [2]肾脏疾病发生与干预湖北省重点实验室,湖北黄石435000 [3]湖北省咸宁市中心医院·湖北科技学院附属第一医院,湖北咸宁437100

出　　处：《中国药业》2025年第4期115-118,共4页China Pharmaceuticals

基　　金：湖北省科技计划项目[2020CFB868];湖北省中医药管理局中医药科研立项项目[ZY2023F070];湖北省黄石市社会科学研究项目[2023sk216]。

摘　　要：目的比较多西环素与阿奇霉素治疗儿童支原体肺炎(MP)的有效性、安全性和经济性。方法选取医院2022年12月1日至2023年11月30日收治的MP患儿(8~14岁)354例,按用药方案的不同分为对照组(248例)和观察组(106例);收集患儿的基线资料,并进行倾向性评分匹配(PSM)。两组患儿均予对症治疗,对照组患儿的加予注射用阿奇霉素静脉滴注,观察组患儿加予注射盐酸用多西环素静脉滴注,两组患儿均持续治疗8~14 d。比较两组患儿临床疗效(退热时间、肺部湿罗音消失时间、咳嗽消失时间、临床总有效率)、安全性(不良反应发生情况)、经济学(直接医疗成本)。结果PSM后,两组均纳入患儿103例,组间基线资料比较,差异均无统计学意义(P>0.05)。观察组患儿的退热时间、咳嗽消失时间、湿罗音消失时间均显著少于对照组;观察组临床总有效率为93.21%,显著高于对照组的87.38%(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(1.94%比1.94%,P>0.05)。观察组相较对照组,可节约成本970.28元,治疗效果增加5.84%,增量成本-效果比为-166.14,敏感性分析结果与之一致。结论多西环素治疗儿童MP的有效性、经济性较阿奇霉素更优,且二者安全性相当。Objective To compare the efficacy,safety,and economy of doxycycline and azithromycin in the treatment of pediatric mycoplasmal pneumonia(MP).Methods A total of 354 children with MP(aged 8 to 14 years)admitted to the hospital from December 1,2022 to November 30,2023 were selected and divided into the control group(248 cases)and the observation group(106 cases)according to different medication regimens;their baseline data were collected and corrected by the propensity score matching(PSM).Both groups received symptomatic treatment,on this basis,the children in the control group received intravenous drip of Azithromycin for Injection,and the children in the observation group received intravenous drip of Doxycycline Hydrochloride for Injection.Both groups were treated for 8-14 d.The clinical efficacy(ecovery time of body temperature,disappearance time of pulmonary wet rales,disappearance time of cough,total clinical effective rate),safety(occurrence of adverse reactions),and economy(direct medical costs)of treatment between the two groups were compared.Results After PSM,103 children were included in each group,and there was no significantly difference in the baseline data between groups(P>0.05).The recovery time of body temperature,disappearance time of cough and disappearance time of pulmonary wet rales in the observation group was significantly less than that in the control group;the total clinical effective rate in the observation group was 93.21%,which was significantly higher than 87.38%in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of children(1.94%vs.1.94%,P>0.05).Compared with that in the control group,the treatment regimen in the observation group could save a cost of CNY 970.28,increase the treatment efficacy by 5.84%,with an incremental cost-effectiveness ratio of-166.14,which is consistent with the sensitivity analysis.Conclusion Doxycycline is more effective and economic than azithromycin in the treatment of pedia

关 键 词：多西环素 阿奇霉素 倾向性评分匹配 有效性 安全性 经济性 

分 类 号：R969.3[医药卫生—药理学]