摘要
目的探究基于肺部CT征象改变、炎症吸收评估阿奇霉素治疗肺炎支原体肺炎(MPP)患儿的效果。方法纳入2022年5月至2024年5月收治的96例MPP患儿作为研究对象,均接受肺部CT检查并分析其形态及分布等特征,所有患儿均给予对症治疗及阿奇霉素治疗,分析患儿治疗前后症状改善、炎症指标变化及CT征象改变,根据阿奇霉素治疗效果分为有效组(n=79)与无效组(n=17),对比两组CT征象特征,并探究其意义。结果96例MPP患儿CT特征中,以肺部实变最为多见,为73.96%,其次是磨玻璃影占60.42%,而后是支气管壁增厚44.79%、含支气管征29.17%、碎石征18.75%、胸腔积液15.63%、淋巴结肿大12.5 0%;经阿奇霉素治疗7d后,患儿CRP、SAA、IL-6、TNF-α、WBC、NE%均显著下降(P<0.05),肺部CT征象(磨玻璃影、肺部实变、含气支气管征、支气管壁增厚、碎石征、胸腔积液、淋巴结肿大)均显著缓解(P<0.05);对比不同实变影MPP患儿炎症指标水平发现,小叶性质变影患儿CPR、SAA、IL-6、TNF-α显著低于大叶性实变影及节段性实变影患儿(P<0.05),大叶性实变影显著低于节段性实变影(P<0.05),三组间均具有显著性差异(P<0.05);有效组患儿肺部CT征象(磨玻璃影、肺部实变、含气支气管征、支气管壁增厚、碎石征、胸腔积液、淋巴结肿大)显示比例均显著低于无效组(P<0.05);二元logistics回归分析显示,磨玻璃影、碎石征、胸腔积液、肺部实变发生情况与MPP患儿治疗预后相关。结论阿奇霉素治疗可改善MPP患儿肺部CT征象,缓解机体炎症反应,临床可根据肺部CT检查结合患儿临床表现,合理评估药物治疗价值与患儿康复情况。
Objective To explore the effect of azithromycin in the treatment of children with mycoplasma pneumoniae pneumonia(MPP)based on the lung CT signs changes and inflammation absorption.Methods 96 children with MPP admitted from May 2022 to May 2024 were enrolled in the study.Lung CT examination was performed on children and the characteristics such as morphology and distribution were analyzed.All children were given symptomatic treatment and azithromycin treatment.The improvements of symptoms,inflammatory indexes and changes of CT signs before and after treatment were analyzed.According to the therapeutic effect of azithromycin,they were divided into effective group(n=79)and ineffective group(n=17).The characteristics of CT signs were compared between groups and the significance was explored.Results Among the CT characteristics of 96 children with MPP,pulmonary consolidation was the most common(73.96%),followed by ground-glass opacity(60.42%),bronchial wall thickening(44.79%),air bronchogram(29.17%),gravel sign(18.75%),pleural effusion(15.63%)and lymph node enlargement(12.50%).After 7 days of azithromycin treatment,the levels of CRP,SAA,IL-6,TNF-α,WBC and NE%were significantly decreased(P<0.05),and the lung CT signs(ground-glass opacity,pulmonary consolidation,air bronchogram,bronchial wall thickening,gravel sign,pleural effusion and lymph node enlargement)were significantly relieved(P<0.05).Comparing the levels of inflammatory indexes in children with MPP with different consolidation shadows,it was found that CPR,SAA,IL-6 and TNF-αin children with lobular consolidation shadow were significantly lower than those in children with lobar consolidation shadow and segmental consolidation shadow(P<0.05),and the levels in children lobar consolidation shadow were significantly lower than those in children with segmental consolidation shadow(P<0.05),and there were obvious differences among the three groups(P<0.05).The proportions of lung CT signs(ground-glass opacity,pulmonary consolidation,air bronchogram,bronchial wall thickening,gravel sign,pleural effusion,lymph node enlargement)were significantly lower in effective group than those in ineffective group(P<0.05).Binary logistic regression analysis showed that the groundglass shadow,gravel sign,pleural effusion and pulmonary consolidation were related to the prognosis of MPP children.Conclusion Azithromycin treatment can improve the lung CT signs of children with MPP and alleviate the body’s inflammatory response.Clinically,the value of drug treatment and the rehabilitation of children can be reasonably evaluated according to the lung CT examination combined with clinical manifestations of children.
作者
张淼
王越
田增春
刘阳
朱彩华
薛海蓉
ZHANG Miao;WANG Yue;TIAN Zeng-chun;LIU Yang;ZHU Cai-hua;XUE Hai-rong(Department of paediatrics,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;Department of Laboratory Medicine,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
出处
《中国CT和MRI杂志》
2025年第8期52-55,共4页
Chinese Journal of CT and MRI
关键词
肺炎支原体肺炎
阿奇霉素
肺部CT
炎症吸收
Mycoplasma Pneumoniae Pneumonia
Azithromycin
Lung CT
Inflammatory Absorption
