甲泼尼龙治疗小儿难治性支原体肺炎的临床效果

目的探究甲泼尼龙治疗小儿难治性支原体肺炎(RMPP)的临床效果。方法选择2017年8月至2018年8月本院收治的56例RMPP患儿作为研究对象,随机将其分为参照组和研究组,各28例。参照组给予常规治疗,同时给予阿奇霉素,研究组在参照组基础上给予甲泼尼龙。比较两组的临床疗效、临床症状改善情况、细胞因子水平、免疫功能指标水平及不良反应发生情况。结果研究组患儿的治疗总有效率为92.86%,显著高于参照组的71.42%(P<0.05)。研究组患儿的咳嗽缓解时间、咯痰时间、肺部啰音消失时间及发热时间均短于对照组,差异具有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-6及CRP水平均显著降低,且研究组低于参照组,差异具有统计学意义(P<0.05);两组CD3^+、CD4^+、CD4^+/CD8^+均升高,CD8^+降低,且研究组优于参照组,差异具有统计学意义(P<0.05)。研究组患儿的不良反应总发生率为3.57%,低于参照组的7.14%,但差异无统计学意义(P>0.05)。结论阿奇霉素联合甲泼尼龙治疗小儿RMPP临床效果显著,可缩短临床症状改善时间,改善细胞因子水平及免疫功能指标水平,且安全性高,值得临床推广。

Clinical effect of methylprednisolone in the treatment of refractory mycoplasma pneumoniae pneumonia in children

Objective To explore the clinical effect of methylprednisolone in the treatment of refractory mycoplasma pneumoniae pneumonia(RMPP) in children. Methods Fifty-six children with RMPP admitted in our hospital from August2017 to August 2018 were selected as the research objects and randomly divided into reference group and research group,with 28 cases in each group. The reference group was treated with routine treatment and intravenous dripazithromycin,while the research group was treated with methylprednisolone on the basis of the reference group. The clinical efficacy,improvement of clinical symptoms, level of cytokine and immune function indexes and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the research group was 92.86%, which was significantly higher than 71.42% in the reference group(P <0.05). The cough relief time, expectoration time, lung rale disappearance time and fever time in the research group were shorter than those in the reference group, and the differences were statistically significant(P<0.05). After treatment, the levels of TNF-α, IL-6 and CRP in the two groups significantly decreased, and those in the research group were lower than the reference group, and the differences were statistically significant(P<0.05);CD3^+, CD4^+, CD4^+/CD8^+in the two groups increased, CD8+decreased, and those in the research group were better than the reference group, and the differences were statistically significant(P <0.05). The total incidence of adverse reactions in the research group was 3.57%, which was lower than 7.14% in the reference group, but there was no significant difference(P>0.05). Conclusion Azithromycin combined with methylprednisolone in the treatment of RMMP in children has a significant clinical effect. It can shorten the improvement time of clinical symptoms, improve the levels of cytokines and immune function indicators, and with high safety, which is worthy of clinical promotion.