糖皮质激素辅助治疗儿童重症肺炎支原体肺炎的临床研究

目的 观察糖皮质激素的合理使用对儿童重症肺炎支原体肺炎(SMPP)的辅助治疗效果.方法 将80例患儿依据随机数表法分为对照组40例与试验组40例.对照组用阿奇霉素序贯治疗:第1～7天,10 mg·kg-1阿奇霉素注射液+葡萄糖注射液250 mL,每天1次,静脉滴注;第8～15天,10 mg·kg-1阿奇霉素分散片,每天...

Clinical trial of glucocorticoid on adjuvant therapy of severe mycoplasma pneumoniae pneumonia in children

Objective To observe the effect of the rational use of corticosteroids on the adjuvant treatment of severe mycoplasma pneumoniae pneumonia(SMPP)in children.Methods According to the random number method,80 children were divided into control group(n=40)and an treatment group(n=40).Control group was treated with azithromycin sequentially:d1-d7,10 mg·kg^-1 azithromycin injection+glucose injection 250 mL,qd,intravenous drip;on d8-d15,10 mg·kg^-1 azithromycin dispersible tablets,qd,orally.Treatment group was treated with glucocorticoids on the basis of control group:d1-d3,1.5 mg·kg^-1 methylprednisolone sodium succinate,qd,intravenous drip;on d4-d15,1.0 mg·kg^-1 methylprednisolone sodium succinate,qd,intravenous drip.The treatment time for both groups was 15 d.The hypersensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),duration of symptoms and signs,treatment effects,and adverse drug reactions in two gorups were compared.Results After treatment,the total effective rates in treatment group and control group were 100.00%(40 cases/40 cases)and 85.00%(34 cases/40 cases),the difference was statistically significant(P<0.05).After treatment,the hs-CRP in treatment group and control group were(9.87±2.72)and(12.25±3.81)mg·L^-1,IL-6 were(5.13±0.72)and(6.62±0.81)pg·mL^-1,TNF-αwere(4.20±1.32)and(4.71±1.77)ng·L^-1,all with significant differences(all P<0.05).The duration of fever in treatment group and control group were(2.01±0.47)and(3.34±0.62)d,the duration of cough were(3.20±0.61)and(5.24±1.22)d,the duration of rales in lungs were(5.37±1.72)and(7.53±1.91)d,the difference were all statistically significant(all P<0.05).The incidence of adverse drug reactions in treatment group and control group were 20.00%and 17.50%,without significant difference(P>0.05).Conclusion Reasonable use of glucocorticoids in the treatment of SMPP children help to improve the treatment effect,improve serum factor indicators,shorten the duration of symptoms and signs.