甲泼尼龙琥珀酸钠联合红霉素治疗儿童肺炎支原体感染合并乳酸脱氢酶升高的临床研究OA北大核心CSTPCD
Clinical trial of methylprednisolone sodium succinate combined with erythromycin in the treatment of Mycoplasma pneumoniae infection with elevated lactate dehydrogenase in children
目的 分析小剂量甲泼尼龙琥珀酸钠联合红霉素治疗儿童肺炎支原体感染合并乳酸脱氢酶(LDH)升高的效果.方法 将LDH升高的肺炎支原体肺炎(MPP)患儿用随机数字表法分为对照组与试验组.对照组给予红霉素治疗,试验组给予小剂量甲泼尼龙琥珀酸钠联合红霉素治疗.记录2组患儿的临床疗效及临床症状消失时间,比较2组治疗前后肺部X线片征象、免疫功能[T细胞亚群(CD4+、CD8+、CD4+/CD8+)、免疫球蛋白(Ig)A、IgM]以及血清LDH变化,并观察药物不良反应发生情况.结果 对照组和试验组各51例.治疗后,试验组的总有效率为96.00％,明显高于对照组的81.63％(P＜0.05).治疗后,试验组和对照组的退热时间分别为(4.22±0.87)和(5.46±0.98)d,咳嗽消失时间分别为(6.31±0.98)和(7.49±1.10)d,肺部啰音消失时间分别为(7.36±1.14)和(8.61±1.23)d,在统计学上差异均有统计学意义(均P＜0.05).治疗后,试验组和对照组的斑片状浸润影征象分别为2.00％和16.33％,支气管壁增厚征象分别为4.00％和18.37％,在统计学上差异均有统计学意义(均P＜0.05).治疗后,试验组和对照组的IgA分别为(0.55±0.11)和(0.68±0.12)g·L-1,IgM 分别为(0.90±0.19)和(1.18±0.21)g·L-1,LDH分别为(229.45±10.30)和(240.18±11.17)U·L-1,在统计学上差异均有统计学意义(均P＜0.05).试验组与对照组患儿药物不良反应总发生率分别为6.00％和4.08％,在统计学上差异无统计学意义(P＞0.05).结论 红霉素联合小剂量甲泼尼龙全身治疗对LDH升高的MPP患儿疗效显著,可促进炎症及免疫紊乱减轻,加速病情转归,安全可靠.
Objective To analyze the effect of low-dose methylprednone sodium succinate combined with erythromycin in the treatment of Mycoplasma pneumoniae infection with elevated lactate dehydrogenase(LDH)in children.Methods Children with Mycoplasma pneumoniae pneumonia(MPP)complicated with elevated LDH were divided into control group and treatment group by random number table method.The control group was given erythromycin treatment,and the treatment group was given low-dose methylprednisolone sodium succinate combined with erythromycin treatment.Clinical efficacy and clinical symptom disappearance time were recorded in both groups.Pulmonary X-ray signs,immune function[T cell subsets(CD4+,CD8+,CD4+/CD8+)],immunoglobulin(Ig)A,IgM and serum LDH were compared between the two groups before and after treatment,and the adverse drug reactions of treatment were observed.Results There were 51 cases in control group and 51 cases in treatment group.The total effective rate in treatment group was 96.00％,which was significantly higher than 81.63％in control group(P＜0.05).The fever abatement times in treatment group and control group were(4.22±0.87)and(5.46±0.98)d;cough disappearance times were(6.31±0.98)and(7.49±1.10)d;disappearance times of pulmonary rales were(7.36±1.14)and(8.61±1.23)d,all with significant difference(all P＜0.05).After treatment,the patchy infiltrating shadow sign rates in treatment group and control group were 2.00％and 16.33％;the bronchial wall thickening sign rates were 4.00％and 18.37％,all with significant difference(all P＜0.05).After treatment,IgA levels in treatment group and control group were(0.55±0.11)and(0.68±0.12)g·L-1;IgM levels were(0.90±0.19)and(1.18±0.21)g·L-1;LDH levels were(229.45±10.30)and(240.18±11.17)U·L-1,all with significant difference(all P＜0.05).The total incidence of adverse drug reactions in treatment group and control group were 6.00％and 4.08％respectively,without significant difference(P＞0.05).Conclusion Erythromycin combined with low-dose methylprednone in systemic treatment of children with MPP and elevated LDH has a significant efficacy,and it can promote the reductions of inflammation and immune disorders and accelerate the disease outcomes,and it is safe and reliable.
阮仁伟;刘晓玲;查梅宝;裴婷;何萍;杨潘婷
安徽医科大学附属安庆市第一人民医院儿科,安徽安庆 246003
药学
甲泼尼龙琥珀酸钠红霉素肺炎支原体肺炎儿童乳酸脱氢酶
methylprednisolone sodium succinateerythromycinMycoplasma pneumoniae pneumoniachildrenlactate dehydrogenase
《中国临床药理学杂志》 2024 (003)
312-316 / 5
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