CAJ | 학술논문

目的：观察不同剂量甲泼尼龙用于肺炎支原体感染患儿及对肿瘤坏死因子-α（TNF-α）的影响。方法将医院收治的72例未接受治疗的支原体肺炎患儿随机分为中等剂量组、小剂量组和常规治疗组，3组患儿均给予阿奇霉素治疗，中等剂量组和小剂量组患儿在此基础上分别给予5 mg/kg和1 mg/kg甲泼尼龙，同时选取来医院进行健康体检的24例健康儿童作为健康对照组。比较4组儿童治疗前、治疗后4 d、治疗后7 d血清TNF-α水平，以及3组患儿的治疗有效率。结果中等剂量组和小剂量组患儿治疗有效率显著高于常规治疗组（ P<0.05），住院时间、胸片部X线摄片阴影消退时间、发热时间均显著低于常规治疗组（ P<0.05）；治疗前，治疗后4 d、治疗后7 d中等剂量组和小剂量组患儿TNF-α水平均无显著差异（ P＞0.05）；中等剂量组和小剂量组患儿TNF-α治疗前、治疗后4 d高于健康对照组（ P<0.05），治疗后7 d与健康对照组无显著差异（ P＞0.05）；常规治疗组治疗前，治疗后4 d、治疗后7 d TNF-α水平均显著高于健康对照组（ P<0.05）。结论中等剂量和小剂量甲泼尼龙均能够显著降低支原体肺炎患儿TNF-α水平，提高治疗有效率。
목적：관찰불동제량갑발니룡용우폐염지원체감염환인급대종류배사인자-α（TNF-α）적영향。방법장의원수치적72례미접수치료적지원체폐염환인수궤분위중등제량조、소제량조화상규치료조，3조환인균급여아기매소치료，중등제량조화소제량조환인재차기출상분별급여5 mg/kg화1 mg/kg갑발니룡，동시선취래의원진행건강체검적24례건강인동작위건강대조조。비교4조인동치료전、치료후4 d、치료후7 d혈청TNF-α수평，이급3조환인적치료유효솔。결과중등제량조화소제량조환인치료유효솔현저고우상규치료조（ P<0.05），주원시간、흉편부X선섭편음영소퇴시간、발열시간균현저저우상규치료조（ P<0.05）；치료전，치료후4 d、치료후7 d중등제량조화소제량조환인TNF-α수평균무현저차이（ P＞0.05）；중등제량조화소제량조환인TNF-α치료전、치료후4 d고우건강대조조（ P<0.05），치료후7 d여건강대조조무현저차이（ P＞0.05）；상규치료조치료전，치료후4 d、치료후7 d TNF-α수평균현저고우건강대조조（ P<0.05）。결론중등제량화소제량갑발니룡균능구현저강저지원체폐염환인TNF-α수평，제고치료유효솔。
Objective To investigate the effect of different doses of methylprednisolone on tumor necrosis factor-α ( TNF-α) in chil-dren with Mycoplasma pneumoniae infection. Methods 72 untreated children patients with Mycoplasma pneumonia admitted to hospital were randomly divided into the middle-dose group, low-dose group and conventional treatment group. The 3 groups were given azithromycin, while on this basis the middle-dose group and the low-dose group were given 5 mg/kg and 1 mg/kg of methylpred-nisolone;at the same time 24 healthy children with physical examination were selected as the healthy control group. The serum TNF-αlevels before treatment, on 4, 7 d after treatment were compared among 4 groups and the treatment effective rates were compared among 3 treatment groups. Resuts The effective rate in the middle-dose group and the low-dose group was significantly higher than that in the conventional treatment group ( P<0. 05 ); the hospitalization time, disappearance time of chest X-ray shadow and fever time were significantly lower than those in the conventional treatment group ( P<0. 05 );serum TNF-α level before treatment, on 4, 7 d after treat-ment had no statistically significant difference between the middle-dose group and the low dose group ( P>0. 05 );serum TNF-α level before treatment, on 4 d after treatment in the middle-dose group and the low-dose was higher than that in the healthy control group ( P<0. 05 ) , but which on 7 d after treatment had no statistically significant difference between the middle dose group and the low-dose group with the healthy control group ( P>0. 05 );serum TNF-α level before treatment, on 4, 7 d after treatment in the convention-al treatment group was significantly higher than that in the healthy control group ( P<0. 05 ) . Conclusion Middle-dose and low-dose methylprednisolone can significantly reduce the serum TNF-α level in children with Mycoplasma pneumonia and improve the treatment effect.