阿奇霉素序贯联合小剂量甲强龙治疗小儿支原体肺炎的效果

doi:10.3760/cma.j.cn441417-20240805-03021

摘要/Abstract

摘要：

目的　探究阿奇霉素序贯联合小剂量甲强龙治疗小儿支原体肺炎（MPP）的效果，以及对血清炎症因子水平的影响。方法　选取2023年1月至2024年3月郑州大学附属儿童医院收治的78例MPP患儿作为研究对象。根据用药方案不同，将患儿分为对照组（39例）与试验组（39例）。对照组男21例，女18例；年龄2～11（5.68±1.03）岁；体重指数（BMI）14.36～17.62（15.25±0.57）kg/m²；病程2～10（4.12±0.62）d。试验组男23例，女16例；年龄2～12（5.65±1.02）岁；BMI 14.30～17.39（15.30±0.55）kg/m²；病程1～9（4.15±0.59）d。对照组采用阿奇霉素序贯治疗（持续治疗5 d后停药3 d，再持续治疗3 d），试验组在对照组基础上联合1～2 mg/kg甲强龙治疗（持续治疗11 d）。比较两组临床疗效，治疗前后血清炎症因子水平［白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）］，治疗期间不良反应发生情况。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　试验组治疗总有效率高于对照组［92.31%（36/39）比74.36%（29/39）］（P<0.05）。治疗后，试验组血清IL-4、IL-6、hs-CRP、TNF-α水平均低于对照组［（9.29±2.18）mg/L比（16.93±3.25）mg/L、（13.09±2.68）ng/L比（18.53±3.75）ng/L、（4.02±0.96）mg/L比（6.78±1.21）mg/L、（15.84±2.56）ng/L比（22.11±3.07）ng/L］（均P<0.05）。治疗期间，两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论　阿奇霉素序贯联合小剂量甲强龙治疗MPP患儿效果较好，可降低血清炎症因子水平，安全性较好。

关键词:

支原体肺炎, 甲强龙, 小剂量, 阿奇霉素序贯疗法, 炎症因子

Abstract:

Objective　To observe the effect of azithromycin sequential therapy combined with low dose methylprednisolone on mycoplasma pneumonia (MPP) in children, and its effects on serum inflammatory factors. Methods　A total of 78 children with MPP admitted to the Children's Hospital Affiliated to Zhengzhou University from January 2023 to March 2024 were selected as the study objects. According to different medication regimens, the children were divided into a control group (39 cases) and an experimental group (39 cases). There were 21 boys and 18 girls in the control group, aged 2-11 (5.68±1.03) years old; the body mass index (BMI) was 14.36-17.62 (15.25±0.57) kg/m²; the course of disease was 2-10 (4.12±0.62) d. There were 23 boys and 16 girls in the experimental group, aged 2-12 (5.65±1.02) years; the BMI was 14.30-17.39 (15.30±0.55) kg/m²; the course of disease was 1-9 (4.15±0.59) d. The control group was given azithromycin sequential therapy (continuous treatment for 5 d followed by withdrawal for 3 d and continued treatment for 3 d), and the experimental group was combined with 1-2 mg/kg of methylprednisolone (continuous treatment for 11 d) on the basis of the control group. The clinical efficacy, occurrence of adverse reactions during treatment, and serum levels of inflammatory factors [interleukin-4 (IL-4), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α)] before and after treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate of the experimental group was higher than that of the control group [92.31% (36/39) vs. 74.36% (29/39)] (P<0.05). After treatment, the levels of serum IL-4, IL-6, hs-CRP, and TNF-α in the experimental group were lower than those in the control group [(9.29±2.18) mg/L vs. (16.93±3.25) mg/L, (13.09±2.68) ng/L vs. (18.53±3.75) ng/L, (4.02±0.96) mg/L vs. (6.78±1.21) mg/L, (15.84±2.56) ng/L vs. (22.11±3.07) ng/L] (all P<0.05). During treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　Low-dose methylprednone combined with azithromycin sequential therapy is effective in the treatment of MPP in children, which can reduce the levels of serum inflammatory factors, with good safety.

Key words:

Mycoplasma pneumonia, Methylprednisolone, Low-dose, Azithromycin sequential therapy, Inflammatory factors

张松林施阳郭燕军.

阿奇霉素序贯联合小剂量甲强龙治疗小儿支原体肺炎的效果 [J]. 国际医药卫生导报, 2025, 31(3): 454-457.

Zhang Songlin, Shi Yang, Guo Yanjun.

Effect of azithromycin sequential therapy combined with low dose methylprednisolone on mycoplasma pneumonia in children [J]. International Medicine and Health Guidance News, 2025, 31(3): 454-457.

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