急支糖浆联合阿奇霉素治疗小儿支原体肺炎的疗效及对炎症因子水平的影响
|
摘要
目的分析急支糖浆联合阿奇霉素治疗小儿支原体肺炎的疗效及对炎症因子水平的影响。方法回顾性选取2014年7月—2016年9月成都市郫都区人民医院收治的小儿支原体肺炎患儿94例,根据治疗方法不同分为对照组和观察组。对照组患儿采用阿奇霉素序贯疗法进行治疗,首先iv阿奇霉素10 mg/(kg·d),连续用药5 d;之后口服阿奇霉素颗粒5 mg/(kg·d),连续用药3 d,停药4 d为1个疗程。观察组患儿在对照组基础上同时口服急支糖浆,根据年龄确定剂量,<3岁者7 mL/次;3～7岁者10 mL/次;7～12岁者15 mL/次,均为3次/d。两组均治疗2个疗程。观察两组患儿症状、体征消失时间、住院时间、不良反应情况、血清炎症因子、基质金属蛋白酶-9(MMP-9)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平变化情况。结果观察组患儿退热时间、咳嗽消失时间、肺部湿啰音消失时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。两组患儿治疗后超敏C-反应蛋白(hs-CRP)、白介素-4(IL-4)、降钙素原(PCT)、MMP-9及MDA水平均较治疗前下降,γ-干扰素(IFN-γ)和超氧化物歧化酶(SOD)水平较治疗前上升,同组治疗前后比较差异均有统计学意义(P<0.05)。观察组患儿治疗后hs-CRP、IL-4、PCT、MMP-9及MDA水平低于对照组,IFN-γ和SOD水平高于对照组,组间差异有统计学意义(P<0.05)。观察组患儿不良反应率为8.16%,对照组为37.78%,观察组患儿不良反应率低于对照组,差异有统计学意义(P<0.05)。结论急支糖浆联合阿奇霉素治疗小儿支原体肺炎疗效确切,可调节患儿血清炎症因子水平,抑制患儿氧自由基产生,且安全性较高。
Objective To analyze the effect of azithromycin and fast syrup on the treatment of mycoplasma pneumonia in children and its influence on the improvement of inflammatory factors. Methods A retrospective selection of children with mycoplasma pneumonia from July 2014 to September 2016 in our hospital 94 cases, according to the different treatment methods were divided into observation group and control group. The control group were treated with Azithromycin Sequential therapy, the observation group were treated with Azithromycin combined with acute bronchitis syrup for treatment. Observation of two groups of children with symptoms, signs disappeared time, hospitalization time, adverse reactions, inflammatory cytokines, matrix metalloproteinase-9(MMP-9), malondialdehyde(MDA), superoxide dismutase(SOD) levels. Results The time of fever, the time of cough disappearance, the time of lung rales disappearance and the length of stay in the observation group were shorter than those in the control group(P < 0.05). The two groups after treatment hs-CRP, IL-4, PCT, MMP-9 and MDA levels were lower than that before treatment, IFN-γ and SOD levels compared with those before treatment(P < 0.05). The levels of hs-CRP, IL-4, PCT, MMP-9 and MDA in the observation group were lower than those in the control group, and the levels of IFN-γ and SOD were higher than that of the control group(P < 0.05). To observe the adverse reaction rate of 8.16% groups, the control group was 37.78%. The adverse reactions in the observation group were lower than control group(P < 0.05). Conclusion Azithromycin Jizhi syrup for the treatment of mycoplasma pneumonia in children is effective, can regulate the level of serum inflammatory factors in children, children with inhibition of oxygen free radicals, and high safety.
Objective To analyze the effect of azithromycin and fast syrup on the treatment of mycoplasma pneumonia in children and its influence on the improvement of inflammatory factors. Methods A retrospective selection of children with mycoplasma pneumonia from July 2014 to September 2016 in our hospital 94 cases, according to the different treatment methods were divided into observation group and control group. The control group were treated with Azithromycin Sequential therapy, the observation group were treated with Azithromycin combined with acute bronchitis syrup for treatment. Observation of two groups of children with symptoms, signs disappeared time, hospitalization time, adverse reactions, inflammatory cytokines, matrix metalloproteinase-9(MMP-9), malondialdehyde(MDA), superoxide dismutase(SOD) levels. Results The time of fever, the time of cough disappearance, the time of lung rales disappearance and the length of stay in the observation group were shorter than those in the control group(P < 0.05). The two groups after treatment hs-CRP, IL-4, PCT, MMP-9 and MDA levels were lower than that before treatment, IFN-γ and SOD levels compared with those before treatment(P < 0.05). The levels of hs-CRP, IL-4, PCT, MMP-9 and MDA in the observation group were lower than those in the control group, and the levels of IFN-γ and SOD were higher than that of the control group(P < 0.05). To observe the adverse reaction rate of 8.16% groups, the control group was 37.78%. The adverse reactions in the observation group were lower than control group(P < 0.05). Conclusion Azithromycin Jizhi syrup for the treatment of mycoplasma pneumonia in children is effective, can regulate the level of serum inflammatory factors in children, children with inhibition of oxygen free radicals, and high safety.
引文
[1]焦素敏,沙玉英,冯雪莉.支原体肺炎患儿阿奇霉素治疗前后C_反应蛋白及心肌酶变化的临床研究[J].中华医院感染学杂志, 2015, 25(21):4888-4890.
[2]韩建东.中药联合阿奇霉素治疗小儿支原体肺炎的疗效及对血清炎性因子的影响[J].西部中医药, 2015, 28(3):121-123.
[3]胡亚美,江载芳.诸福棠实用儿科学[M].北京:人民卫生出版社, 2002:318-319.
[4]高芳,王永霞,高心静.肺炎支原体感染患儿肺外并发症的临床研究[J].中华医院感染学杂志, 2014, 24(4):1010-1011.
[5]赵小花,沈国武,徐长艳.阿奇霉素对小儿支原体肺炎患者C反应蛋白与心肌酶含量影响及临床疗效[J].中国医院药学杂志, 2014, 23(7):562-564.
[6]张倩.小儿肺炎支原体肺炎临床诊治探讨[J].河北医学, 2015, 21(5):823-824.
[7]陈嘉慧,印根权,余嘉璐,等.红霉素与阿奇霉素治疗小儿肺炎支原体肺炎的临床研究[J].中国临床药理学杂志, 2015, 31(8):587-589.
[8]张延峰,薛继红.红霉素与阿奇霉素序贯治疗儿童肺炎支原体肺炎疗效观察[J].儿科药学杂志, 2015, 21(8):20-22.
[9]徐美荣.急支糖浆佐治儿童肺炎疗效观察[J].中国保健营养:中旬刊, 2014, 7(7):4535-4535.
[10]姚伟光,陈青.玉屏风散辅助常规治疗对支原体肺炎患儿血浆氧自由基及心肌酶水平的影响[J].中华中医药学刊, 2015, 33(6):1501-1504.
[11] Nishikawa A, Mimura K, Kanagawa T, et al.Thrombocytopenia associated with Mycoplasma pneumonia during pregnancy:Case presentation and approach for differential diagnosis[J]. J Obstetr Gynaecol Res, 2015, 41(8):1273-1277.
[12]李莉,高春雁.红霉素序贯疗法对小儿支原体肺炎患者免疫球蛋白、细胞因子的影响[J].临床肺科杂志,2016, 21(4):732-736.
[13]周成,王书举,翟玉峰,等.布地奈德雾化吸入对支原体肺炎患儿炎症因子与免疫功能的影响[J].中华医院感染学杂志, 2016, 26(9):2136-2138.
[14]李小象,周莉,赵亮,等.脾氨肽口服冻干粉联合阿奇霉素治疗小儿支原体肺炎的疗效及对免疫功能的影响[J].药物评价研究, 2017, 40(7):950-954.
[15]赵丽燕.婴幼儿肺炎支原体肺炎急性期与恢复期免疫功能及炎症因子变化[J].中国妇幼保健, 2014, 29(1):86-88.
[16] Biondi E, McCulloh R, Alverson B, et al. Treatment of mycoplasma pneumonia:A systematic review[J].Pediatrics, 2014, 133(6):1081-1090.
[2]韩建东.中药联合阿奇霉素治疗小儿支原体肺炎的疗效及对血清炎性因子的影响[J].西部中医药, 2015, 28(3):121-123.
[3]胡亚美,江载芳.诸福棠实用儿科学[M].北京:人民卫生出版社, 2002:318-319.
[4]高芳,王永霞,高心静.肺炎支原体感染患儿肺外并发症的临床研究[J].中华医院感染学杂志, 2014, 24(4):1010-1011.
[5]赵小花,沈国武,徐长艳.阿奇霉素对小儿支原体肺炎患者C反应蛋白与心肌酶含量影响及临床疗效[J].中国医院药学杂志, 2014, 23(7):562-564.
[6]张倩.小儿肺炎支原体肺炎临床诊治探讨[J].河北医学, 2015, 21(5):823-824.
[7]陈嘉慧,印根权,余嘉璐,等.红霉素与阿奇霉素治疗小儿肺炎支原体肺炎的临床研究[J].中国临床药理学杂志, 2015, 31(8):587-589.
[8]张延峰,薛继红.红霉素与阿奇霉素序贯治疗儿童肺炎支原体肺炎疗效观察[J].儿科药学杂志, 2015, 21(8):20-22.
[9]徐美荣.急支糖浆佐治儿童肺炎疗效观察[J].中国保健营养:中旬刊, 2014, 7(7):4535-4535.
[10]姚伟光,陈青.玉屏风散辅助常规治疗对支原体肺炎患儿血浆氧自由基及心肌酶水平的影响[J].中华中医药学刊, 2015, 33(6):1501-1504.
[11] Nishikawa A, Mimura K, Kanagawa T, et al.Thrombocytopenia associated with Mycoplasma pneumonia during pregnancy:Case presentation and approach for differential diagnosis[J]. J Obstetr Gynaecol Res, 2015, 41(8):1273-1277.
[12]李莉,高春雁.红霉素序贯疗法对小儿支原体肺炎患者免疫球蛋白、细胞因子的影响[J].临床肺科杂志,2016, 21(4):732-736.
[13]周成,王书举,翟玉峰,等.布地奈德雾化吸入对支原体肺炎患儿炎症因子与免疫功能的影响[J].中华医院感染学杂志, 2016, 26(9):2136-2138.
[14]李小象,周莉,赵亮,等.脾氨肽口服冻干粉联合阿奇霉素治疗小儿支原体肺炎的疗效及对免疫功能的影响[J].药物评价研究, 2017, 40(7):950-954.
[15]赵丽燕.婴幼儿肺炎支原体肺炎急性期与恢复期免疫功能及炎症因子变化[J].中国妇幼保健, 2014, 29(1):86-88.
[16] Biondi E, McCulloh R, Alverson B, et al. Treatment of mycoplasma pneumonia:A systematic review[J].Pediatrics, 2014, 133(6):1081-1090.