感染、炎症、修复
感染、炎癥、脩複
감염、염증、수복
INFECTION， INFLAMMATION， REPAIR
2014年
4期
221-224
,共4页
糖皮质激素%阿奇霉素%支原体肺炎%炎性因子
糖皮質激素%阿奇黴素%支原體肺炎%炎性因子
당피질격소%아기매소%지원체폐염%염성인자
Small doses of glucocorticoids%Azithromycin%Mycoplasma pneumonia%Inflammatory cytokines
目的：：探讨小剂量糖皮质激素联合阿奇霉素治疗儿科支原体肺炎的临床疗效。方法：2011年1月—2014年1月北京怀柔医院就诊及住院的300例儿科支原体肺炎患者随机分为两组。对照组150例患者单用阿奇霉素10 mg·kg-1·d-1静脉滴注；观察组150例患者在阿奇霉素常规治疗基础上,给予小剂量甲泼尼龙琥珀酸钠0.2 mg·kg-1·d-1静脉滴注。治疗7 d时分别检测两组细胞免疫相关指标(CD4+和CD8+)及炎症相关指标[C反应蛋白(CRP)、血沉(ESR)、TNF-α、IL-2、IL-6),观察两组患儿症状和体征改善的时间。结果：与单用阿奇霉素组相比,阿奇霉素与甲泼尼龙琥珀酸钠联合用药组不仅能够缩短退热时间、咳嗽消失时间、啰音消失时间、住院时间,而且能够降低 CD8+水平(P<0.05),升高 CD4+/CD8+比值(P<0.01),降低 CRP、ESR、TNF-α、IL-2、IL-6的水平(P<0.05)。观察组患儿的症状、体征消失时间均较对照组提前,且痊愈率明显高于对照组(82.0%比56.7%,P<0.05),恶心、呕吐等不良反应明显少于对照组(2.7%比19.3%,P<0.05)。结论：小剂量糖皮质激素联合阿奇霉素治疗儿科支原体肺炎,患者症状、体征得到较快控制,病程缩短,并发症少,具有较好的疗效。
目的：：探討小劑量糖皮質激素聯閤阿奇黴素治療兒科支原體肺炎的臨床療效。方法：2011年1月—2014年1月北京懷柔醫院就診及住院的300例兒科支原體肺炎患者隨機分為兩組。對照組150例患者單用阿奇黴素10 mg·kg-1·d-1靜脈滴註；觀察組150例患者在阿奇黴素常規治療基礎上,給予小劑量甲潑尼龍琥珀痠鈉0.2 mg·kg-1·d-1靜脈滴註。治療7 d時分彆檢測兩組細胞免疫相關指標(CD4+和CD8+)及炎癥相關指標[C反應蛋白(CRP)、血沉(ESR)、TNF-α、IL-2、IL-6),觀察兩組患兒癥狀和體徵改善的時間。結果：與單用阿奇黴素組相比,阿奇黴素與甲潑尼龍琥珀痠鈉聯閤用藥組不僅能夠縮短退熱時間、咳嗽消失時間、啰音消失時間、住院時間,而且能夠降低 CD8+水平(P<0.05),升高 CD4+/CD8+比值(P<0.01),降低 CRP、ESR、TNF-α、IL-2、IL-6的水平(P<0.05)。觀察組患兒的癥狀、體徵消失時間均較對照組提前,且痊愈率明顯高于對照組(82.0%比56.7%,P<0.05),噁心、嘔吐等不良反應明顯少于對照組(2.7%比19.3%,P<0.05)。結論：小劑量糖皮質激素聯閤阿奇黴素治療兒科支原體肺炎,患者癥狀、體徵得到較快控製,病程縮短,併髮癥少,具有較好的療效。
목적：：탐토소제량당피질격소연합아기매소치료인과지원체폐염적림상료효。방법：2011년1월—2014년1월북경부유의원취진급주원적300례인과지원체폐염환자수궤분위량조。대조조150례환자단용아기매소10 mg·kg-1·d-1정맥적주；관찰조150례환자재아기매소상규치료기출상,급여소제량갑발니룡호박산납0.2 mg·kg-1·d-1정맥적주。치료7 d시분별검측량조세포면역상관지표(CD4+화CD8+)급염증상관지표[C반응단백(CRP)、혈침(ESR)、TNF-α、IL-2、IL-6),관찰량조환인증상화체정개선적시간。결과：여단용아기매소조상비,아기매소여갑발니룡호박산납연합용약조불부능구축단퇴열시간、해수소실시간、라음소실시간、주원시간,이차능구강저 CD8+수평(P<0.05),승고 CD4+/CD8+비치(P<0.01),강저 CRP、ESR、TNF-α、IL-2、IL-6적수평(P<0.05)。관찰조환인적증상、체정소실시간균교대조조제전,차전유솔명현고우대조조(82.0%비56.7%,P<0.05),악심、구토등불량반응명현소우대조조(2.7%비19.3%,P<0.05)。결론：소제량당피질격소연합아기매소치료인과지원체폐염,환자증상、체정득도교쾌공제,병정축단,병발증소,구유교호적료효。
Objective:To investigate the clinical efficacy of small doses of glucocorticoid combined with azithro-mycin in treating pediatric mycoplasmal pneumonia. Methods:Three hundred cases of mycoplasma pneumonia ped-iatric patients admitted to Beijing Huairou Hospital from January 2011 to January 2014 were randomly divided into two groups.Patients in the control group (n=150)were treated with injection of azithromycin 10 mg·kg-1 ·d-1 intravenously. In the observation group (n=150),patients received the treatment of injection of azithromycin 10 mg·kg-1 ·d-1 and a low dose of methylprednisolone sodium succinate 0.2 mg·kg-1 ·d-1 intravenously. Af-ter 7 days of treatment,blood was sampled to determine the levels of CD4+,CD8+,C-reactive protein (CRP), erythrocyte sedimentation rate (ESR),tumor necrosis factor-α(TNF-α),interleukin-2 (IL-2),IL-6. The time of improvement of symptoms and signs were also observed. Results:Compared to single azithromycin treatment,az-ithromycin combined with low dose of methylprednisolone sodium succinate could lower the temperature faster, shorten the cough disappearance time,rales disappearance time and hospital stay time,reduce the level of CD8+(all P<0.05),increased CD4+/CD8+ levels (P<0.01),and reduce CRP,ESR,TNF-α,IL-2,IL-6 levels (P<0.05). The symptoms and signs of patients in the observation group disappeared earlier than that of the con-trol group,with a higher effective rate(P<0.05). The recovery rates were 82.0% and 56.7%,and the rates of complications were 2.7% and 1 9.3% in the observation group and control group,respectively,and the differences were significant (P<0.05).Conclusions:Treatment with small doses of glucocorticoid combined with azithromy-cin can alleviate symptoms and signs,shorten the treatment course with better curative effects and less complica-tions in pediatric myocoplasmal pneumonia.
