中国合理用药探索2025，Vol.22Issue(3)：87-93,7.DOI:10.3969/j.issn.2096-3327.2025.03.015
不同剂量甲泼尼龙联合多西环素治疗儿童大环内酯类耐药重症肺炎支原体肺炎的效果
Efficacy of Different Doses of Methylprednisolone Combined with Doxycycline in the Treatment of Children with Macrolide Antibiotics-Resistant Severe Mycoplasma Pneumoniae Pneumonia
贾彩萍 1李文斌 1孟慧琴 1毕玲莉 1张方方 1秦新芳 1徐伟伟 1田艳荣 1张帆1
作者信息
- 1. 焦作市妇幼保健院呼吸科,焦作 454000
- 折叠
摘要
Abstract
Objective:To investigate the efficacy of different doses of methylprednisolone combined with doxycycline in the treatment of children with macrolide antibiotics-resistant severe Mycoplasma pneumoniae pneumonia(SMPP).Methods:A total of 82 pediatric patients with macrolide antibiotics-resistant SMPP treated in a hospital from March 2023 to April 2024 were selected and assigned to the control group and the observation group by random number table method,with 41 patients in each group.Both groups were given conventional symptomatic and supportive treatment.The control group was treated with 2 mg/(kg·d)of methylprednisolone sodium succinate for injection combined with doxycycline hyclate for injection,and the observation group was treated with 5 mg/(kg·d)of methylprednisolone sodium succinate for injection combined with doxycycline hyclate for injection.Both groups were treated for 7 days.The improvement of chest computed tomography(CT),inflammatory indicator[C reactive protein(CRP)],immune function indicators(CD4+,CD8+),lung function[forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC)],time to disappearance of main symptoms,clinical efficacy and adverse reactions were compared between the two groups.Results:After treatment,the improvement of chest CT in the observation group was superior than that in the control group(P<0.05).The levels of CRP and CD8+were decreased in both groups(P<0.05),with the observation group showing lower levels than the control group(P<0.05).The CD4+level was increased in both groups(P<0.05),with the observation group showing higher levels than the control group(P<0.05).The levels of FEV1,PEF and FVC were increased in both groups(P<0.05),with the observation group showing higher levels than the control group(P<0.05).The time to disappearance of main symptoms for cough,fever,wheezing and lung wet rales in the observation group was shorter than that in the control group(P<0.05).The total effective rate in the observation group(92.68%)was higher than that in the control group(73.17%,P<0.05).No statistically significant difference was observed in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:High-dose methylprednisolone combined with doxycycline in the treatment of children with macrolide antibiotics-resistant SMPP can improve the clinical efficacy,improving the lung function and immune function,without increasing the risk of adverse reactions.关键词
肺炎支原体肺炎/重症肺炎/大环内酯类耐药/甲泼尼龙/多西环素Key words
Mycoplasma pneumoniae pneumonia/severe pneumonia/macrolide-resistant/methylprednisolone/doxycycline分类
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贾彩萍,李文斌,孟慧琴,毕玲莉,张方方,秦新芳,徐伟伟,田艳荣,张帆..不同剂量甲泼尼龙联合多西环素治疗儿童大环内酯类耐药重症肺炎支原体肺炎的效果[J].中国合理用药探索,2025,22(3):87-93,7.
