甲泼尼龙联合阿奇霉素治疗儿童重症肺炎支原体肺炎的疗效及安全性  

Efficacy and safety of methylprednisolone combined with azithromycin in the treatment of severe mycoplasma pneumoniae pneumonia in children

作　　者：林权 林响 胡丽风 邱雨虹 叶丽芳 LIN Quan;LIN Xiang;HU Lifeng;QIU Yuhong;YE Lifang(Department of Paediatrics,Fuzhou Second General Hospital,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院儿科,350007

出　　处：《临床合理用药》2025年第6期42-46,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：福州市“十四五”临床专科培强培优培育建设项目(20220205)。

摘　　要：目的观察甲泼尼龙联合阿奇霉素治疗儿童重症肺炎支原体肺炎的疗效及安全性。方法回顾性分析2021年1月—2023年12月福州市第二总医院收治的78例重症肺炎支原体肺炎患儿临床资料,按治疗方案不同分为甲泼尼龙组和阿奇霉素组,各39例。2组患儿均接受对症治疗,在此基础上,阿奇霉素组给予注射用阿奇霉素,甲泼尼龙组在阿奇霉素组基础上给予注射用甲泼尼龙琥珀酸钠,2组均持续治疗7 d。比较2组患儿临床疗效,退热时间与咳嗽、肺部啰音、肺部病灶消失时间,治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC]、炎性因子[超敏C反应蛋白(hs-CRP)、乳酸脱氢酶(LDH)及白介素-6(IL-6)]及D-二聚体(D-D),不良反应。结果甲泼尼龙组患儿治疗总有效率高于阿奇霉素组(97.44%vs.76.92%,χ^(2)=7.341,P=0.007)。甲泼尼龙组患儿退热时间与咳嗽、肺部啰音、肺部病灶消失时间短于阿奇霉素组(P<0.01)。治疗7 d后,2组FEV_(1)、FVC及FEV_(1)/FVC升高,且甲泼尼龙组高于阿奇霉素组(P<0.01);2组血清hs-CRP、LDH及IL-6水平及血浆D-D水平降低,且甲泼尼龙组低于阿奇霉素组(P<0.01)。阿奇霉素组与甲泼尼龙组不良反应总发生率比较,差异无统计学意义(7.69%vs.12.82%,χ^(2)=0.139,P=0.709)。结论儿童重症肺炎支原体肺炎采用甲泼尼龙联合阿奇霉素治疗的效果良好,可快速缓解症状,减轻炎性反应,改善肺功能,且安全性有保障。Objective To compare the efficacy and safety of methylprednisolone combined with azithromycin in the treatment of severe mycoplasma pneumoniae pneumonia in children.Methods The clinical data of 78 children with severe mycoplasma pneumoniae pneumonia admitted to the Fuzhou Second General Hospital from January 2021 to December 2023 were retrospectively analysed,and they were divided into the methylprednisolone group and the azithromycin group according to the treatment methods,with 39 cases in each group.Children in the two groups were received symptomatic treatment,on the basis of this,the azithromycin group were given azithromycin for injection,and the methylprednisolone group were given sodium methylprednisolone succinate for injection on the basis of the azithromycin group.Both groups were treated for 7 days.The treatment was compared between the two groups in terms of clinical efficacy,antipyretic time,the disappearance time of cough,lung rales and lung lesions,pulmonary function indexes(FEV_(1),FVC,FEV_(1)/FVC),inflammatory factors(hs-CRP,LDH,IL-6),D-D before and after treatment,and adverse reactions.Results The overall effective rate of treatment in the methylprednisolone group was higher than that in the azithromycin group(97.44%vs.76.92%,χ^(2)=7.341,P=0.007).In the methylprednisolone group,antipyretic time,the disappearance time of cough,lung rales and lung lesions were shorter than those in the azithromycin group(P<0.01).After 7 days of treatment,FEV_(1),FVC and FEV_(1)/FVC increased in the two groups,and the methylprednisolone group were higher than those of the azithromycin group(P<0.01);Serum hs-CRP,LDH,IL-6 levels and plasma D-D level decreased in the two groups,and the methylprednisolone group were lower than those of the azithromycin group(P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the azithromycin group and the methylprednisolone group(7.69%vs.12.82%,χ^(2)=0.139,P=0.709).Conclusion Severe mycoplasma pneumoniae pneumonia in childre

关 键 词：重症肺炎支原体肺炎 甲泼尼龙 阿奇霉素 肺功能 炎性因子 安全性 

分 类 号：R725.6[医药卫生—儿科]