阿奇霉素序贯疗法联合双黄连口服液治疗小儿支原体肺炎的临床疗效及其对血清炎性因子水平和免疫功能的影响

摘要

目的：观察阿奇霉素序贯疗法联合双黄连口服液治疗小儿支原体肺炎的临床疗效，探讨其对血清炎性因子水平和免疫功能的影响。方法选取枣庄矿业集团枣庄医院2014年1月—2015年1月收治的支原体肺炎患儿100例，按照随机数字表法分为对照组和观察组，每组50例。两组患儿入院后均给予对症支持治疗，对照组患儿给予阿奇霉素序贯疗法，连续治疗2个疗程；观察组患儿在对照组基础上联合双黄连口服液连续治疗2周。比较两组患儿临床疗效，治疗前后血清炎性因子〔白介素6（IL-6）、白介素8（IL-8）、肿瘤坏死因子α（TNF-α）〕水平、T 淋巴细胞亚群（CD ＋3细胞分数、CD ＋4细胞分数和 CD ＋8细胞分数）及治疗期间不良反应发生情况。结果观察组患儿临床疗效优于对照组（P ﹤0.05）。治疗前两组患儿血清 IL-6、IL-8和TNF-α水平比较，差异无统计学意义（P ﹥0.05）。治疗后观察组患儿血清 IL-6、IL-8和TNF-α水平低于对照组（P ﹤0.05）；两组患儿治疗后血清 IL-6、IL-8和TNF-α水平低于治疗前（P ﹤0.05）。治疗前两组患儿 CD ＋3细胞分数、CD ＋4细胞分数和 CD ＋8细胞分数比较，差异无统计学意义（ P ﹥0.05）；治疗后观察组患儿 CD ＋3细胞分数、CD ＋4细胞分数高于对照组，CD ＋8细胞分数低于对照组（P ﹤0.05）；两组患儿治疗后 CD ＋3细胞分数、CD ＋4细胞分数高于治疗前，CD ＋8细胞分数低于治疗前（P ﹤0.05）。两组患儿治疗期间不良反应发生率比较，差异无统计学意义（P ﹥0.05）。结论阿奇霉素序贯疗法联合双黄连口服液治疗小儿支原体肺炎的临床疗效确切，可有效降低血清炎性因子水平，改善免疫功能，且安全性较高。%Objective To observe the clinical effect of azithromycin sequential therapy combined with shuanghuanglian oral solution on pediatric mycoplasma pneumonia,to investigate the impact on serum inflammatory cytokines levels and immunologic function. Methods A total of 100 children with mycoplasma pneumonia were selected in Zaozhuang Hospital of Zaozhuang Mining Group from January 2014 to January 2015,and they were divided into control group and observation group according to random number table,each of 50 cases. Children of the two groups received symptomatic and supportive treatment after admission,meanwhile children of control group were given azithromycin sequential therapy for two courses of treatment,while children of observation group were given shuanghuanglian oral solution for two weeks based on that of control group. Clinical effect,serum inflammatory cytokines( including IL-6,IL-8 and TNF-α) levels and T - lymphocyte subsets (including CD +3 cell percentage,CD +4 cell percentage and CD +8 cell percentage) before and after treatment,and incidence of adverse reactions during the treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group(P ﹤ 0. 05). No statistically significant differences of serum level of IL-6,IL-8 or TNF-α was found between the two groups before treatment(P ﹥ 0. 05). After treatment,serum levels of IL-6, IL-8 and TNF-α of observation group were statistically significantly lower than those of control group(P ﹤ 0. 05);serum levels of IL-6,IL-8 and TNF-α of the two groups were statistically significantly lower than those before treatment( P ﹤ 0. 05). No statistically significant differences of CD +3 cell percentage,CD +4 cell percentage or CD +8 cell percentage was found between the two groups before treatment(P ﹥ 0. 05). After treatment,CD +3 cell percentage and CD +4 cell percentage of observation group were statistically significantly higher than those of control group,while CD +8 cell percentage of observation group was statistically significantly lower than that of control group(P ﹤ 0. 05);CD +3 cell percentage and CD +4 cell percentage of the two groups were statistically significantly higher than those before treatment,while CD +8 cell percentage of the two groups was statistically significantly lower than that before treatment,respectively(P ﹤ 0. 05). No statistically significant differences of incidence of adverse reactions was found between the two groups during the treatment( P ﹥ 0. 05). Conclusion Azithromycin sequential therapy combined with shuanghuanglian oral solution has certain clinical effect in treating pediatric mycoplasma pneumonia,can effectively reduce the serum inflammatory cytokines levels,improve the immunologic function,and is safe.