糖皮质激素治疗儿童肺炎支原体大叶性肺炎的价值

摘要

目的 探讨糖皮质激素治疗儿童肺炎支原体大叶性肺炎的临床价值.方法 以收治的肺炎支原体大叶性肺炎患儿155例,采用随机数字表法分为观察组(n=78)和对照组(n=77).对照组给予阿奇霉素治疗,观察组给予阿奇霉素+糖皮质激素治疗.比较2组治疗前后的炎性指标[C反应蛋白(CRP)、红细胞沉降率(ESR)、白介素-2(IL-2)、IL-6]、肺功能指标[1 s用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)、PEF25、PEF50、PEF75和PEF25-75]、热退时间、咳嗽消失时间、肺部阴影吸收时间,并在治疗3周后,进行疗效评价.结果 观察组热退时间、咳嗽减轻时间、肺部阴影吸收时间均短于对照组(t=3.896、3.911、4.782,P<0.05).观察组治疗后的CRP、ESR、IL-2、IL-6、PEF50、PEF75和PEF25-75均好于对照组(t=5.112、5.648、3.625、3.770、3.926、3.887、3.846, P<0.05).观察组治疗总有效率为97.44%高于对照组的89.61%,差异有统计学意义(χ2=3.932,P<0.05).结论 相比于单纯采用阿奇霉素治疗,阿奇霉素+糖皮质类激素治疗儿童肺炎支原体大叶性肺炎具有更好的效果.%Objective To investigate the clinical velue of glucocorticoids in treatment of pneumonia mycoplasma lobar pneumonia in children. Methods A total of 155 children patients with pneumonia mycoplasma lobar pneumonia were randomly divided into observation group (n=78) and control group (n=77). The patients in control group were treated by azithromycin,however,the patients in observation group were treated by azithromycin + glucocorticoids. The inflammatory indexes including CRP,ESR,IL-2, IL-6, and lung function indexes including FEV1,FVC,PEF,PEF25,PEF50,PEF75, PEF25-75,time of fever withdrawing,disappearing time of cough, absorption time of pulmonary shadow before and after treatment were observed and compared between two groups. Moreover the therapeutic effects were evaluated after 3-week treatment for both groups.Results The time of fever withdrawing,disappearing time of cough, absorption time of pulmonary shadow in observation group were significantly shorter than those in control group(P<0.05).After treatment the CRP,ESR, IL-2,IL-6,PEF50,PEF75 and PEF25-75 in observation group were superior to those in control group (P<0.05).Moreover the total effective rate in observation group was significantly higher than that in control group (97.44% vs 89.61%,P <0.05). Conclusion As compared with simple application of azithromycin, the azithromycin plus glucocorticoids can get better therapeutic effects on pneumonia mycoplasma lobar pneumonia in children.