多西环素和左氧氟沙星治疗儿童MUMPP的疗效比较  

Comparison of the efficacy of doxycycline and levofloxacin in the treatment of mycoplasma pneumonia in children with macrolide non-response pneumoniae

作　　者：杜霜圆 罗蓉[1] 宋玉萍 DU Shuangyuan;LUO Rong;SONG Yuping(Department of Respiratory Medicine,Children’s Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院呼吸科/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室,重庆400014

出　　处：《重庆医学》2025年第4期933-937,共5页Chongqing Medical Journal

基　　金：重庆市卫生健康委员会医学科研项目(2024wsjk014)。

摘　　要：目的比较多西环素和左氧氟沙星对儿童大环内酯类药物无反应性肺炎支原体肺炎(MUMPP)的疗效及不良反应。方法回顾性分析2023年11月至2024年7月该院收治的240例MUMPP患儿临床资料,根据用药情况分为多西环素组及左氧氟沙星组,每组120例。比较两组疗效、用退热药后体温降至正常时间、咳嗽减轻时间、肺部啰音消失时间、住院时间、外周血指标[WBC、中性粒细胞百分比、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、D-二聚体]、肺部影像学恢复及不良反应发生情况。结果多西环素组和左氧氟沙星组总有效率比较(93.33%vs.90.00%),差异无统计学意义(P<0.05)。与左氧氟沙星组比较,多西环素组住院时间更短[(6.22±2.24)d vs.(7.39±2.47)d],肺部啰音消失时间更长[(4.47±2.06)d vs.(3.50±1.79)d],差异有统计学意义(P<0.05)。治疗后,两组中性粒细胞百分比、CRP、LDH水平低于治疗前,差异有统计学意义(P<0.05)。多西环素组和左氧氟沙星组不良反应发生率比较(15.83%vs.15.00%),差异无统计学意义(P>0.05)。结论多西环素或左氧氟沙星对MUMPP患儿的疗效均较好,不良反应发生率低,无严重不良反应。Objective To compare the efficacy and adverse reactions of doxycycline and levofloxacin in children with macrolide non-responsive mycoplasma pneumonia(MUMPP).Methods Clinical data of 240 MUMPP children admitted to our hospital from November 2023 to July 2024 were retrospectively analyzed,and they were divided into doxycycline group and levofloxacin group according to drug use,with 120 cases in each group.The efficacy of the two groups were compared,the time when body temperature dropped to normal after taking antipyretics,the time when cough was reduced,the time when lung riles were resolved,the length of hospital stay,the peripheral blood indicators[WBC,neutrophilic granulocyte percentage,C reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer],the lung imaging recovery and the occurrence of adverse reactions.Results There was no significant difference in total effective rate between doxycycline group and levofloxacin group(93.33%vs.90.00%,P<0.05).Compared with levofloxacin group,the duration of hospital stay in doxycycline group was shorter[(6.22±2.24)d vs.(7.39±2.47)d],and the duration of lung crackles disappeared longer[(4.47±2.06)d vs.(3.50±1.79)d],with statistical significance(P<0.05).After treatment,the neutrophil percentage,CRP and LDH levels in the two groups were lower than before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between doxycycline group and levofloxacin group(15.83%vs.15.00%,P>0.05).Conclusion Both doxycycline and levofloxacin have good efficacy in MUMPP children,with low incidence of adverse reactions and no serious adverse reactions.

关 键 词：儿童 肺炎支原体肺炎 多西环素 左氧氟沙星 疗效 

分 类 号：R725.6[医药卫生—儿科]