儿童肺炎支原体肺炎早期免疫干预临床分析

目的探讨布地奈德联合孟鲁司特早期干预缓解肺炎支原体(MP)肺炎咳喘症状及预防哮喘发作的临床疗效。方法将MP肺炎患儿240例随机分为布地奈德治疗组(BUD组)、孟鲁司特治疗组(MK组)、布地奈德联合孟鲁司特治疗组(BUD+MK组)和对照组各60例,对照组采用常规抗支原体治疗;在对照组治疗基础上BUD组加用布地奈德氧气雾化吸入,MK组加用孟鲁司特钠口服,BUD+MK组应用布地奈德联合孟鲁司特治疗。观察4组患儿入院时,入院后3、7d咳嗽评分,以及咳喘消失时间、住院时间、6个月内哮喘发作情况。结果 BUD+MK组、BUD组、MK组在入院3、7d时咳嗽评分均低于对照组,咳嗽消失时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。BUD+MK组在入院3、7d时咳嗽评分均低于BUD组、MK组,咳嗽消失时间、住院时间均短于BUD组、MK组,差异有统计学意义(P<0.05)。随访6个月内,BUD+MK组、BUD组、MK组患儿哮喘发病率均低于对照组,BUD+MK组低于BUD组、MK组,差异均有统计学意义(P<0.05)。结论布地奈德、孟鲁司特早期干预治疗MP肺炎均能有效改善咳喘症状,降低哮喘发病率,布地奈德、孟鲁司特联合用药优于单独用药。

Clinical analysis of early immunologic intervention in the treatment of children mycoplasma pneumonia

Objective To explore the curative effect of budesonide combined with montelukast in the prevention and treatment of cough and dyspnea and asthma in children with mycoplasma pneumonia （MP） at early stage. Methods 240 children with MP were randomly divided into budisonide group（ BUD group） ,montelukast group （MK group） ,budisonide and montelukast group （BUD-MK group） and control group,60 cases in each group. The control group was Oven conventional treatment;based on the control group, the BUD group was added with budisonide oxygen aerosol inhalation, the MK group plused montelukast and the BUD-MK group were treated with budesonide combined with montelukast. The cough score on admission and 3 ,Td after admission,cough asthma disappear time,hospital stays and the incidence of asthma in 6 months among 4 groups were compared. Results Compared with the control group, the resolution time of cough and wheeze and the hospital stays in BUD group,MK group and BUD-MK group were obviously shorter, and the cough score on 3,7d after admission was obviously lower, and the differences were statistically significant （ P 〈 0.05 ）. The cough score on 3,7d after admission in BUDMK group was significantly lower than that of the BUD group and MK group ;the resolution time of cough and wheeze and the hospital stays were shorter than those of the BUD group and MK group, and the differences were statistically significant （ P 〈 0.05）. Followed up for 6 months, the incidence of asthma in the BUD group, MK group and BUD-MK group were significantly lower than that of the control group, and the BUD-MK group was much lower than BUD group and MK group, and the differences were statistically significant（P 〈 0.05）. Conclusion Budesonide combined with montelukast can improve cough and asthma symptoms,reduce the incidence of asthma in children with MP. And the combined treatment is better than medicine alone.