甲泼尼龙治疗儿童难治性肺炎支原体肺炎的疗效观察

摘要

目的：探讨甲泼尼龙治疗儿童难治性肺炎支原体肺炎的疗效。方法：选取2015年4月—2016年3月开封市儿童医院收治的难治性支原体肺炎患儿140例作为研究对象，随机分为观察组和对照组各70例。对照组患儿给予常规对症治疗，观察组患儿在常规治疗基础上给予甲泼尼龙治疗。治疗3d后，观察患儿退热情况的同时进行软性支气管镜检查与肺泡灌洗术，测定支气管肺泡灌洗液（ branchoalveolar lavage fluid，BALF）中细胞因子水平。结果：观察组退热率明显高于对照组，观察组咳嗽时间明显低于对照组，差异均有统计学意义（P＜0．05）；2组患儿BALF中细胞因子水平的差异无统计学意义（P＞0．05）；观察组患儿中，退热患儿白细胞介素12与白细胞介素8的水平显著低于非退热患儿，差异有统计学意义（ P＜0．05）。结论：在使用抗菌药物的前提下同时使用甲泼尼龙治疗儿童难治性肺炎支原体肺炎，可减缓临床症状，加快恢复速度。%OBJECTIVE:To probe into the efficacy of methylprednisolone in treatment of children with refractory mycoplasma pneumoniae.METHODS: 140 children with refractory mycoplasma pneumoniae admitted into Kaifeng Children’s Hospital from Apr.2015 to Mar.2016 were selected to be divided into observation group and control group via the random number table, with 70 cases in each.The control group were treated with conventional symptomatic treatment, while the observation group additionally received methylprednisolone based on the control group.After treatment of 3 d, the fever rate of two groups were observed, and bronchoalveolar lavage and flexible bronchoscopy were conducted;cytokine production was determined in branchoalveolar lavage fluid(BALF).RESULTS: The fever rate after three days in observation group was significantly higher than that of control group, while the cough length of observation group was significantly shorter than that of control group, with statistically significant difference ( P 0.05).Of the observation group, the level of IL-12 and IL-8 in fever-group was significantly lower than that of non-fever group, with statistically significant difference ( P <0.05 ) .CONCLUSIONS: Under the conditions of use of antibiotics, methylprednisolone in treatment of children with refractory mycoplasma pneumoniae can relief the clinical symptoms and accelerate the recovery of children.