米诺环素联合甲强龙治疗小儿难治性肺炎支原体肺炎疗效观察

目的观察米诺环素联合甲强龙治疗小儿难治性肺炎支原体肺炎(RMPP)的临床疗效。方法深圳市龙岗区妇幼保健院儿科2014年3月至2015年3月收治RMPP患儿88例,随机分为观察组和对照组各44例。对照组应用阿奇霉素进行常规治疗,观察组在应用阿奇霉素治疗1周后,开始口服米诺环素,持续用药5d;同时静脉滴注甲强龙,持续用药5d,然后改为口服泼尼松,视患儿病情逐渐减量,持续用药7d。观察两组患儿症状体征缓解时间、住院时间、炎症指标及不良反应。结果观察组患儿咳嗽缓解时间、退热时间及住院时间均显著短于对照组,差异有统计学意义(P0.05);治疗后两组患儿各项炎性指标水平均较治疗前显著降低,差异有统计学意义(P0.05);观察组治疗后C反应蛋白、血沉、白细胞计数水平均显著低于对照组,差异有统计学意义(P0.05);治疗2周后观察组肺部阴影吸收率为81.82%(36/44),显著高于对照组43.18%(19/44),差异有统计学意义(P0.05)。结论临床治疗RMPP联合应用甲强龙和米诺环素,能迅速改善临床症状,提高治疗效果。

Observation on the clinical effects of minocycline combined with methylprednisolone in the treatment of children with refractory mycoplasma pneumoniae pneumonia

Objective To observe the clinical effects of minocycline combined with methylprednisolone in the treatment of children with refractory mycoplasma pneumoniae pneumonia(RMPP).Methods Totally 88 children with RMPP who accepted treatments in Department of Pediatrics,Maternity and Child Health Care Hospital of Longgang District,from March 2014 to March 201 5,were taken as the research subjects, and these patients were randomly divided into the control group and the observation group,with 44 patients in each group.In the control group,they were treated with azithromycin for routine treatment,while in the observation group,they were treated with azithromycin for 1 week and then oral minocycline was taken,med-ication continuing for 5 d;at the same time they were treated with the intravenous infusion of methylpred-nisolone for 5 d,then it was changed to oral prednisone,the dosage being reduced gradually according to pa-tients'condition for 7 days.Then,the symptom relief time,hospitalization time,inflammation index and ad-verse reaction of the two groups were observed.Results The cough relief time,cooling time and hospitaliza-tion time of children in the observation group were significantly shorter than those in the control group,and the difference was statistically significant(P <0.05).After treatment,the levels of inflammatory markers of the two groups were significantly lower than before treatment,and the difference was statistically significant (P <0.05).After treatment,the C reaction protein,ESR and WBC count in the observation group were sig-nificantly lower than those in the control group,and the difference was statistically significant(P <0.05).After two weeks of treatment,the lung shadow absorption rate in the observation group was 81.82%(36/44),which was significantly higher than that in the control group[43.18%(19/44)]and the difference was statistically signifi-cant(P <0.05).Conclusion In the clinical treatment for RMPP,combination with methylprednisolone and minocycline can rapidly improve the clinical symptoms and thus improve the treatment effect.