摘要
目的研究不同剂量糖皮质激素与克拉霉素联合应用治疗小儿重症肺炎支原体肺炎的效果。方法选取2019年6月至2021年8月河北北方学院附属第一医院收治的156例重症肺炎支原体肺炎患儿作为研究对象,根据随机数字表法分为对照组(36例)、观察组(40例)、常量组(43例)及小量组(37例)。对照组行阿奇霉素治疗,观察组行克拉霉素治疗,常量组行克拉霉素联合常规剂量糖皮质激素[1.0 mg/(kg·d)]治疗,小量组行克拉霉素联合小剂量糖皮质激素[2.0 mg/(kg·d)]治疗。比较各组临床指标、外周血炎症指标及不良反应发生情况。结果观察组退热天数、咳嗽缓解天数及肺部杂音消失天数短于对照组(P<0.05);常量组、小量组退热天数、咳嗽缓解天数及肺部杂音消失天数短于观察组(P<0.05);小量组咳嗽缓解天数短于观察组(P<0.05)。治疗后,对照组和观察组超敏C反应蛋白(hs-CRP)、血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)水平低于治疗前(P<0.05);观察组SAA水平低于对照组(P<0.05)。治疗后,观察组、常量组、小量组hs-CRP、SAA、IL-6水平低于治疗前(P<0.05);各组hs-CRP水平比较,差异有统计学意义(P<0.05);常量组SAA水平高于观察组(P<0.05);小量组SAA水平低于常量组(P<0.05)。观察组与对照组不良反应总发生率比较,差异无统计学意义(P>0.05)。常量组、小量组不良反应总发生率低于观察组(P>0.05)。结论克拉霉素在治疗小儿重症肺炎支原体肺炎中较阿奇霉素具有优势,糖皮质激素联合克拉霉素可应用于小儿重症肺炎支原体肺炎治疗并推广。
Objective To study the effect of different doses of glucocorticoid combined with Clarithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children.Methods A total of 156 children with severe Mycoplasma pneumoniae pneumonia treated in the First Affiliated Hospital of Hebei North University from June 2019 to August 2021 were selected as research objects.They were divided into the control group(36 cases),the observation group(40 cases),the constant group(43 cases),and the small dose group(37 cases)according to the random number table method.The control group was treated with Azithromycin,the observation group was treated with Clarithromycin,the constant group was treated with Clarithromycin combined with conventional dose glucocorticoid[1.0 mg/(kg·d)],and the small dose group was treated with Clarithromycin combined with low dose glucocorticoid[2.0 mg/(kg·d)].Clinical indexes,peripheral blood inflammatory indexes,and adverse reactions of each group were compared.Results The days of antipyretic,cough remission,and disappearance of pulmonary murmur in the observation group were shorter than those in the control group(P<0.05);and the days of antipyretic,cough remission and disappearance of pulmonary murmur in the constant group and small dose group were shorter than those in the observation group(P<0.05);the days of cough remission in the small dose group were shorter than those in the constant group(P<0.05).After treatment,the levels of hypersensitive C-reactive protein(hs-CRP),serum amyloid A(SAA),and interleukin-6(IL-6)in control group and observation group were lower than before treatment(P<0.05);SAA level in observation group was lower than that in control group(P<0.05).After treatment,the levels of Hs-CRP,SAA,and IL-6 in the observation group,constant group,and small dose group were lower than those before treatment(P<0.05);there was statistical significance in hs-CRP level among all groups(P<0.05);SAA level in the constant group was higher than that in the observation group(P<0.05);SAA level in the small dose group was lower than that in the constant group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(P>0.05);the total incidence of adverse reactions in the constant group and the small dose group were lower than that the in observation group(P>0.05).Conclusion Clarithromycin has advantages over Azithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children.Glucocorticoid combined with Clarithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children can be applied and popularized.
作者
段娜娜
荣伟强
郑茂东
颜娟
左路广
DUAN Nana;RONG Weiqiang;ZHENG Maodong;YAN Juan;ZUO Luguang(Department of Pharmacy,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Blood Transfusion,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Departmentof Laboratory,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China)
出处
《中国医药导报》
CAS
2022年第23期89-92,103,共5页
China Medical Herald
基金
河北省医学科学研究课题计划项目(20211499)。
关键词
肺炎支原体肺炎
重症肺炎
克拉霉素
糖皮质激素
剂量差异
疗效
Mycoplasma pneumoniae pneumonia
Severe pneumonia
Clarithromycin
Glucocorticoid
Dose difference
Curative effect
