阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染的疗效、安全性及对炎性因子水平的影响

摘要

目的：探讨阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染的疗效、安全性及对炎性因子水平的影响。方法选择学龄前支原体肺炎患儿120例，随机分为序贯1组、序贯2组，每组60例。2组均给予补液、退热、止咳、祛痰等常规治疗，在此基础上，序贯1组给予阿奇霉素静脉滴注3d，停用4d后改为阿奇霉素干混悬剂口服7d；序贯2组给予阿奇霉素静脉滴注5d，停用4d后改为阿奇霉素干混悬剂口服5d。观察2组疗效、不良反应，治疗前及治疗后3 d、7 d、14 d血清IL－6、IL－10及CRP水平的变化。结果2组治疗14 d有效率比较差异无统计学意义；2组治疗后退热、啰音消失、X射线片恢复正常时间及咳嗽控制时间比较差异均无统计学意义（P均＞0．05）；序贯1组不良反应发生率明显低于序贯2组（P＜0.05）；2组治疗后各时间段血清IL－6、IL－10及CRP水平与治疗前比较差异均有统计学意义（P均＜0．05），治疗3 d后2组血清IL－6、IL－10及CRP水平均明显下降，治疗14 d各指标达正常水平，2组间比较差异均无统计学意义。结论阿奇霉素序贯疗法治疗学龄前儿童肺炎支原体感染疗效显著，可有效降低血清炎性因子水平，且静脉用药3d的序贯疗法安全性更高。%Objective It is to explore the efficacy, safety and effect of azithromycin sequential therapy on inflammatory cy-tokines in preschool children with pneumonia mycoplasma infection.Methods 180 cases of preschool children with mycoplas-ma pneumonia were selected and were divided into sequential groupⅠ, sequential groupⅡrandomly, with 60 cases in each group.Based on the basic therapy of fever, cough, expectorant, rehydration, the patients of sequential group Ⅰ were given intravenous infusion of azithromyc for 3 d, and used azithromycin for suspension oral treatment 7 d with 4 d after discontinua-tion;the patients of sequential groupⅡwere given intravenous infusion of azithromyc for 5 d, and used azithromycin for sus-pension oral treatment 5 d with 4 d after discontinuation.The curative effect, adverse reactions and the change of serum levels of IL-6, IL-10 and CRP before treatment and 3 d,7 d,14 d after treatment were observed in both groups.Results There was no significant difference in 14 d efficiency, defervesce, rales disappeared, X-ray sheet returned to normal time and cough control time between the two groups (P>0.05).The adverse reaction rates of sequential groupⅠwas significantly low-er than that of sequential groupⅡ(P<0.05).After treatment serum there were significant differences in IL-6, IL-10 and CRP between the two groups at each time stage (P all<0.05), the levels of IL-6, IL-10 and CRP were decreased obvious-ly after treatment for 3 days in both groups, and the indexes reach normal level after treatment for 14 days, there was no signif-icant differences between the two groups.Conclusion The efficacy of Azithromycin sequential therapy in the treatment of My-coplasma pneumoniae infection in preschool children is significant, which can effectively improve the level of serum inflamma-tory cytokines, with a higher safety when using 3 d intravenous drug sequential therapy.