多西环素在儿童重症肺炎支原体肺炎中的应用价值

摘要]目的：观察多西环素对8岁以上儿童重症肺炎支原体肺炎（SMPP）的疗效。方法：回顾性研究我院2017-2019年年龄>8岁SMPP住院患儿的病历资料，随机抽取使用多西环素病例46例为多西环素组和使用阿奇霉素病例52例为阿奇霉素组。多西环素组患儿给予多西环素口服（2.2 mg/kg，bid），阿奇霉素组患儿给予阿奇霉素静脉滴注（10 mg/kg，qd），疗程5~7 d，比较两组患儿的退热时间、咳嗽缓解时间、肺部啰音消失时间、住院时间、激素使用率及血常规、C反应蛋白（CRP）、乳酸脱氢酶（LDH）、肺内病变吸收等情况。结果：两组患儿均治愈或好转，多西环素组退热时间、咳嗽缓解时间、肺部啰音消失时间、住院时间、糖皮质激素使用率及LDH、CRP水平均短于或低于阿奇霉素组，肺内病变吸收率高于阿奇霉素组（P均<0.05）。结论：8岁以上儿童SMPP口服多西环素治疗安全、有效、价廉。

Application Value of Doxycycline in Children with Severe Mycoplasma Pneumoniae Pneumonia

Abstract] Objective: To observe the efficacy of doxycycline in severe Mycoplasma pneumoniae pneumonia (SMPP) in children over 8 years old. Methods: Medical records of children over 8 years old with SMPP in our hospital from 2017 to 2019 were retrospectively analyzed. Forty-six patients with doxycycline were randomly extracted as the doxycycline group and 52 cases with azithromycin were randomly selected as the azithromycin group. Doxycycline group was given doxycycline orally (2.2 mg/kg, bid), and azithromycin group was given azithromycin by intravenous infusion (10 mg/kg, qd), both groups were treated for 5 to 7 d. The duration of fever, relief time of cough, disappearance time of pulmonary rales, length of stay, application rate of hormone, blood routine, C-reactive protein (CRP), lactate dehydrogenase (LDH), absorption of pulmonary lesions in two groups were compared. Results: Children in both groups were cured or improved. The duration of fever, relief time of cough, disappearance time of pulmonary rales, length of stay, application rate of hormone, LDH and CRP in the doxycycline group were shorter or lower than those in the azithromycin group, the absorption rate was higher than that of the azithromycin group (P<0.05). Conclusion: Oral doxycycline treatment for SMPP in children over 8 years old is safe, effective and inexpensive.