| 谭红梅,谭春梅,冯晓丽,李培培,潘 彬.阿奇霉素联合糖皮质激素治疗重症支原体肺炎患儿的临床效果分析[J].,2017,17(26):5079-5082 |
| 阿奇霉素联合糖皮质激素治疗重症支原体肺炎患儿的临床效果分析 |
| Analysis of Clinical Efficacy of Azithromycin Combined Glucocorticoids in Treatment of Severe Pneumonia Mycoplasma |
| 投稿时间：2017-03-11 修订日期：2017-04-08 |
| DOI：10.13241/j.cnki.pmb.2017.26.016 |
| 中文关键词: 重症支原体肺炎 阿奇霉素 糖皮质激素 |
| 英文关键词: Severe mycoplasma pneumonia Azithromycin Glucocorticoids |
| 基金项目:四川省卫生厅科研基金项目(000092) |
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| 中文摘要: |
| 摘要 目的：分析阿奇霉素联合糖皮质激素治疗重症支原体肺炎患儿的临床效果及安全性。方法：选择112例重症支原体肺炎患儿并通过抽签法分为对照组与观察组，每组各56例。对照组予以阿奇霉素治疗，观察组在对照组基础上加用糖皮质激素治疗。观察并比较两组患儿治疗前后血沉(ESR)、血清乳酸脱氢酶(LDH)、同工酶MB(CK-MB)、肌酸激酶(CK)、谷草转氨酶(AST)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平、CD4+及CD8+，临床疗效及不良反应的发生情况。结果：观察组有效率为96.4%，显著高于对照组(82.1%)，差异有统计学意义(P<0.05)。治疗后，两组ESR、血清LDH、CK-MB、CK、AST、CRP、IL-6、TNF-α水平及CD8+均较治疗前显著降低，且观察组以上指标均明显低于对照组；两组CD4+均较治疗前明显上升，且观察组显著高于对照组，差异均有统计学意义(P<0.05)。观察组退热、咳嗽缓解、肺部湿啰音消失时间均明显短于对照组(P<0.05)。两组不良反应的发生情况比较差异无统计学意义(P>0.05)。结论：阿奇霉素联合糖皮质激素治疗小儿重症支原体肺炎的临床效果明显优于单用阿奇霉素治疗，可有效减轻心肌损伤和炎症反应，并提高患儿免疫功能，且安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influences of azithromycinantibiotic combined glucocorticoids on the levels of erythrocyte sedimentation rate(ESR), serum lactate dehydrogenase (LDH) and inflammatory cytokines levels as well as the clinical effect of severe pneumonia mycoplasma. Methods: 112 children with severe pneumonia mycoplasma who were treated in our hospital were selected and randomly divided into the control group and the observation group with 56 cases in each group. The patients in the control group were treated with azithromycinantibiotic, while the patients in the observation group were treated with glucocorticoid on the basis of the control group. Then the levels of ESR, LDH, isoenzyme MB (CK-MB), creatine kinase (CK), aspertate aminotransferase (AST), c-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor-α(TNF-α), CD4+ and CD8+, the clinical efficacy and adverse reactions between two groups were observed and compared before and after the treatment. Results: The effective rate in the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of ESR, LDH, CK-MB, CK, AST, CRP, IL-6, TNF-α and CD8+ in the two groups decreased, which were lower in the observation group than those of the control group (P<0.05). After treatment, the levels of CD4+ in both groups increased, which was higher in the observation group than that of the control group(P<0.05). The disappearance time of fever, cough relief, lung rale of observation group were shorter than those of the control group(P<0.05). There was no statistically significant difference in the adverse reactions between the two groups (P>0.05). Conclusion: Azithromycin combined with glucocorticoids was more effective than azithromycin alone in the treatment of severe mycoplasma pneumonia with high safety, which could obviously relieve the myocardial injury and inflammatory response, enhance the immune function. |
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