Objective To investigate the effects of azithromycin and erythromycin in the treatment of children with mycoplasma pneumonia.Methods Ninety-four cases of children with mycoplasma pneumonia were selected,which were treated in the department of pediatrics in the 202nd Hospital of PLA from February 2016 to February 2017,and they were divided into the observation group (47 cases) and control group (47 cases).The patients of two groups were all treated with cough,expectorant,fever,reduction of intracranial pressure,nutritional nerve and other conventional therapy.The patients of control group were treated with injection of erythromycin lactobionate (20 mg · kg-1 · d-1),sterile water for injection 10 ml to 0.5 g dissolved in erythromycin lactobacillin bottle shake dissolved,dissolved in 250 ml 0.9％ sodium chloride injection for intravenous infusion,1 week later changed to oral erythromycin tablets 10 mg · kg-1 · d-1).The patients of observation group were treated with azithromycin (dissolved in 250 ml 0.9％ sodium chloride injection for intravenous infusion,1 week later changed to oral azithromycin 7.5 mg · kg-1 · d-1.The children of 2 groups were all treated for 3 weeks.Compare the clinical symptoms of remission time,length of stay,clinical efficacy,adverse reactions and changes of the levels of TNF-α,IL-4,IL-6,hs-CRP inflammatory cell levels,blood gas analysis index of the two groups.Results After the appropriate treatment,the total effective rate of the observation group was 95.7％,which was significantly higher than 78.7％ of the control group (x2 =5.045;P =0.025);The fever time,asthma time,cough disappearance time,wet rales disappear time,hospital stay of the observation group were significantly lower than those of the control group (t =3.295,t =3.908,t =9.265,t =4.583,t =5.710;P =0.000,P =0.000,P =0.000,P =0.000,P =0.000);The TNF-α,IL-4,IL-6,hs-CRP levels of the observation group were significantly lower than those of the control group (t =3.586,t =4.727,t =3.754,t =3.832;P =0.000,P =0.000,P =0.000,P =0.000);The PaO2,SaO2 levels of the observation group were significantly higher than those of the control group,and the PaCO2 levels of the observation group were significantly lower than those of the control group (t =2.525,t =2.838,t =2.384,P =0.007,P =0.003,P =0.019);There were nausea,vomiting,elevated serum creatinine,rash and other adverse reactions occurred in both two groups,but there were no statistically significant between the two groups (x2 =1.195,x2 =0.435,x2 =0.319,x2 =1.472;P =0.274,P =0.509,P =0.572,P =0.225).Conclusion The clinical effect of azithromycin in the treatment of mycoplasma pneumonia is superior to that of erythromycin,which can significantly decrease the levels of TNF-α,IL-4 and IL-6 inflammatory cells,improve blood gas analysis index,and its safety is good,which makes it worthy of clinical promotion.%目的 观察红霉素与阿奇霉素治疗支原体肺炎患儿的效果及相关指标的比较.方法 选择2016年2月-2017年2月解放军第202医院儿科收治支原体肺炎患儿94例作为研究对象,按照随机数字表法分为观察组和对照组各47例.2组患儿均给予止咳、祛痰、退热、降颅压、营养神经等常规治疗.对照组给注射用乳糖酸红霉素20 mg·kg-1·d-1,溶入0.9％氯化钠注射液250ml静脉滴注;1周后改为红霉素片10 mg·kg-1·d-1口服.观察组给予阿奇霉素10 mg·kg-1·d-1,溶入0.9％氯化钠注射液250 ml静脉滴注;1周后调整剂量为口服阿奇霉素7.5 mg·kg-1·d-1.2组患儿疗程均为3周.比较2组患儿临床疗效,临床症状缓解时间及住院时间,治疗前后TNF-α、IL-4、IL-6、hs-CRP炎性因子水平、血气分析指标,并比较2组患儿不良反应发生情况.结果 治疗后观察组总有效率95.7％显著高于对照组78.7％(x2=5.045,P=0.025);观察组在退热时间、平喘时间、咳嗽消失时间、湿啰音消失时间、住院时间明显低于对照组(t=3.295、3.908、9.265、4.583、5.710,P均=0.000);观察组血清TNF-α、IL-4、IL-6、hs-CRP水平显著低于对照组(t=3.586、4.727、3.754、3.832,P均=0.000);观察组PaO2、SaO2水平显著高于对照组,PaCO2水平显著低于对照组(t=2.525、2.838、2.384,P=0.007、0.003、0.019);2组间各不良反应发生率比较,差异无统计学意义(P＞0.05).结论 阿奇霉素治疗支原体肺炎患儿临床效果优于红霉素,能显著降低TNF-α、IL-4、IL-6等炎性因子水平,改善血气分析指标,安全性好,值得临床推广.
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