多西环素、左氧氟沙星治疗儿童大环内酯类药物无反应性肺炎支原体肺炎效果比较  

Comparison of efficacy of doxycycline and levofloxacin in the treatment of children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia

作　　者：罗自豪 任佩珍 李少军[2] 王艳红[1] 耿刚[1] LUO Zihao;REN Peizhen;LI Shaojun;WANG Yanhong;GENG Gang(Department of Respiratory Medicine,Children´s Hospital of Chongqing Medical University,Chongqing 400014,China;不详)

机构地区：[1]重庆医科大学附属儿童医院呼吸科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014 [2]重庆医科大学附属儿童医院急诊科,重庆400014

出　　处：《山东医药》2025年第4期1-5,共5页Shandong Medical Journal

基　　金：重庆市自然科学基金面上项目(CSTB2023NSCQ-MSX0495)。

摘　　要：目的比较多西环素、左氧氟沙星治疗儿童大环内酯类药物无反应性肺炎支原体肺炎(MUMPP)的效果。方法197例MUMPP患儿按照用药不同分为多西环素组(71例)和左氧氟沙星组(126例)。多西环素组静脉输注盐酸多西环素:每次2 mg/kg,每12 h输注1次(早上9︰00、晚上21︰00),用药总疗程10 d。左氧氟沙星组静脉输注左氧氟沙星氯化钠注射液:5岁以下儿童使用剂量为每次10 mg/kg,每12 h输注1次(早上9︰00、晚上21︰00);5岁及以上儿童使用剂量为每次10 mg/kg,1天输注1次(早上9︰00);用药总疗程14 d。比较两组总有效率、临床表现、炎症指标、肺部异常密度影及药物不良反应。结果两组总有效率比较,P>0.05。与左氧氟沙星组比较,多西环素组住院天数短(P<0.05);两组用药后发热天数、肺部体征明显缓解天数、咳嗽明显缓解天数比较,P均>0.05。与同组治疗前比较,两组治疗后白细胞计数、C反应蛋白、纤维蛋白原、降钙素原水平均降低(P均<0.05);两组治疗后上述炎症指标比较,P均>0.05。两组肺部异常密度影较治疗前基本或完全消失比例及不良反应比较,P均>0.05。结论多西环素、左氧氟沙星治疗MUMPP患儿均有效,两药疗效无明显差异,均较为安全,未见严重不良反应,但多西环素较左氧氟沙星住院时间短。Objective To compare the efficacy of doxycycline and levofloxacin in the treatment of macrolide-unre-sponsive Mycoplasma pneumoniae pneumonia(MUMPP)in children.Methods A total of 197 children with MUMPP were divided into two groups based on treatment:the doxycycline group(71 cases)and the levofloxacin group(126 cas-es).The doxycycline group received intravenous doxycycline hydrochloride[2 mg/(kg·dose)]every 12 hours(at 9:00 a.m.and 9:00 p.m.)for a total course of 10 days.The levofloxacin group received intravenous levofloxacin and sodium chloride injection:children under 5 years received 10 mg/(kg·dose)every 12 hours(at 9:00 a.m.and 9:00 p.m.),while children aged 5 years and above received 10 mg/kg once daily(at 9:00 a.m.)for a total course of 14 days.We com-pared the total effective rate,clinical manifestations,inflammatory markers,pulmonary abnormal densities,and adverse drug reactions between the two groups.Results The comparison of the total effective rates between the two groups showed no significant difference(P>0.05).Compared with the levofloxacin group,the doxycycline group had a shorter hospital stay(P<0.05).There were no significant differences in the days of fever,days of significant relief of pulmonary signs,or days of significant relief of cough after treatment between the two groups(all P>0.05).The white blood cells,C-reactive protein,fibrinogen,and procalcitonin levels decreased in both groups after treatment as compared with those be-fore treatment in the same group(all P<0.05);but no significant differences were found in these inflammatory markers be-tween the two groups after treatment(all P>0.05).Additionally,there were no significant differences in the proportion of resolution or near-resolution of pulmonary abnormal densities or adverse reactions between the two groups(all P>0.05).Conclusions Both doxycycline and levofloxacin are effective in treating MUMPP in children with no significant differ-ence in efficacy.Both drugs are found to be safe,with no severe adverse reactions reported.Howev

关 键 词：多西环素 左氧氟沙星 肺炎支原体肺炎 大环内酯类药物无反应性肺炎支原体肺炎 

分 类 号：R725.6[医药卫生—儿科]