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目的:探讨静脉滴注甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效及其对相关实验室指标的影响。方法:选择2014年6月至2015年12月我院收治的难治性支原体肺炎患儿106例,依据随机数字表法分为观察组和对照组各53例。对照组给予阿奇霉素治疗,观察组在对照组治疗基础上静脉滴注甲泼尼龙,两组患儿疗程均为5 d,比较两组患儿临床疗效、症状和体征消退时间、药物不良反应及治疗前后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、D-二聚体水平。结果:观察组患儿治疗总有效率为96.23%,高于对照组的79.25%(P<0.05);观察组咳嗽缓解时间、退热时间及肺部阴影消退时间均明显短于对照组(P<0.05);两组患儿血清CRP、TNF-α、D-二聚体水平治疗后明显降低(P<0.05);观察组血清CRP、TNF-α、D-二聚体水平治疗后低于对照组(P<0.05);两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论:静脉滴注甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎疗效显著,安全性好,其作用机制可能与降低CRP、TNF-α、D-二聚体水平有关。
Objective: To investigate the curative effect of intravenous methylprednisolone combined with azithromycin on children refractory mycoplasma pneumonia and its influence on related laboratory indexes. Methods: A total of 106 children with refractory mycoplasma pneumonia admitted in our hospital from June 2014 to December 2015 were selected and divided into observation group and control group according to random number table. The control group was treated with azithromycin. The observation group received intravenous methylprednisolone infusion on the basis of the control group. The course of treatment for both groups was 5 days. The clinical efficacy, symptom and symptom subsidence time, adverse drug reaction and treatment were compared between the two groups Serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and D-dimer levels before and after treatment. Results: The total effective rate of treatment group was 96.23%, which was higher than that of control group (79.25%, P <0.05). The cough relief time, antipyretic time and lung shadow remission time in the observation group were significantly shorter than those in the control group <0.05). Serum levels of CRP, TNF-α and D-dimer in both groups were significantly lower after treatment (P <0.05). The levels of CRP, TNF-α and D-dimer in the observation group were lower than those before treatment (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: Intravenous injection of methylprednisolone combined with azithromycin in children with refractory mycoplasma pneumonia is effective and safe. The possible mechanism may be related to decreasing the levels of CRP, TNF-α and D-dimer.