普米克令舒对重症肺炎支原体肺炎患儿肺功能的影响
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摘要
目的探讨普米克令舒对重症肺炎支原体肺炎患儿肺功能的影响。方法选择2015年10月至2017年2月本院小儿急诊科收治的50例重症肺炎支原体肺炎患儿,随机分为试验组(25例)和对照组(25例),对照组采用阿奇霉素+对症治疗,试验组在对照组治疗基础上加用普米克令舒,两组疗均为5 d。比较2组受试者肺功能、疾病疗效及临床症状体征消失时间。结果肺功能各项指标治疗前后的变化值:试验组PEF、FEV1、FEV1/FVC、V75、V50、V25分别为(16.27±3.03)%、(14.24±2.23)%、(9.53±1.75)%、(9.51±1.30)%、(18.53±3.67)%、(17.15±5.37)%,对照组分别为(13.57±2.63)%、(10.52±2.53)%、(7.62±1.32)%、(6.75±1.34)%、(14.37±4.37)%、(11.20±8.52)%,两组比较差异均有统计学意义(P<0.05);住院时间及症状体征消失时间:试验组住院时间、胸片转阴时间、咳嗽消失时间、啰音消失时间、发热消退时间分别为(6.02±2.62)d、(5.12±2.32)d、(4.26±3.91)d、(3.20±2.91)d、(3.23±2.07)d,对照组分别为(7.82±3.09)d、(6.62±1.97)d、(6.72±4.20)d、(4.91±3.07)d、(5.17±2.91)d,两组比较差异均有统计学意义(P<0.05);疾病疗效:试验组总有效率为92.00%,对照组总有效率为72.00%,两组比较差异均有统计学意义(P<0.05)。结论短时间合用普米克令舒治疗重症肺炎支原体肺炎,能明显缩短疗程、改善肺功能、提高疾病疗效。
Objective To evaluate the effect of Pulmicort respulas on lung function of the children with severe Mycoplasma pneumoniae pneumonia(MPP). Methods 50 children admitted in the Emergency Medicine of Pediatrics,Qingdao Women and Children' s Hospital from October 2015 to February 2017 were divided into treatment group(25 cases) and control group(25 cases). Patients in the control group were treated by azithromycin and symptomatic treatment,and those in the treatment group were treated with Pulmicort respulas in addition to the treatment given in the control group. The course of treatment was 5 days. The lung function,therapeutic effect and the disappearance time of clinical symptoms and signs between the two groups were compared before and after treatment. Results The change values of various indexes of lung function before and after treatment,i.e. PEF,FEV1,FEV1/FVC,V75,V50,V25 in the treatment group were(16.27±3.03) %,(14. 24 ± 2. 23) %,(9. 53 ± 1. 75) %,(9. 51 ± 1. 30) %,(18. 53 ± 3. 67) %,(17. 15 ± 5. 37) %respectively,and(13.57±2.63) %,(10.52±2.53) %,(7.62± 1.32) %,(6.75± 1.34) %,(14.37± 4.37) %,(11.20± 8.52) % respectively in the control group. The hospital stay and the disappearance time of clinical symptoms and signs,the time for negative signs on X-ray,cough disappearance,rale disappearance and fever subsidence in the treatment group were(6.02±2.62) days,(5.12± 2.32) days,(4.26± 3.91) days,(3.20±2.91) days and(3.23±2.07) days respectively;(7.82±3.09) days,(6.62±1.97) days,(6.72±4.20) days,(4.91± 3.07) days and(5.17± 2.91) days respectively in the control group. The total effective rate of the treatment group was 92.00%,and that of the control group was 72.00%.All above indexes showed statistical differences between the two groups(P<0.05).ConclusionRoutine treatment plus a short time of Pulmicort respulas administration could shorten the treatment course,improve lung function and ameliorate the therapeutic effect of severe MPP.
Objective To evaluate the effect of Pulmicort respulas on lung function of the children with severe Mycoplasma pneumoniae pneumonia(MPP). Methods 50 children admitted in the Emergency Medicine of Pediatrics,Qingdao Women and Children' s Hospital from October 2015 to February 2017 were divided into treatment group(25 cases) and control group(25 cases). Patients in the control group were treated by azithromycin and symptomatic treatment,and those in the treatment group were treated with Pulmicort respulas in addition to the treatment given in the control group. The course of treatment was 5 days. The lung function,therapeutic effect and the disappearance time of clinical symptoms and signs between the two groups were compared before and after treatment. Results The change values of various indexes of lung function before and after treatment,i.e. PEF,FEV1,FEV1/FVC,V75,V50,V25 in the treatment group were(16.27±3.03) %,(14. 24 ± 2. 23) %,(9. 53 ± 1. 75) %,(9. 51 ± 1. 30) %,(18. 53 ± 3. 67) %,(17. 15 ± 5. 37) %respectively,and(13.57±2.63) %,(10.52±2.53) %,(7.62± 1.32) %,(6.75± 1.34) %,(14.37± 4.37) %,(11.20± 8.52) % respectively in the control group. The hospital stay and the disappearance time of clinical symptoms and signs,the time for negative signs on X-ray,cough disappearance,rale disappearance and fever subsidence in the treatment group were(6.02±2.62) days,(5.12± 2.32) days,(4.26± 3.91) days,(3.20±2.91) days and(3.23±2.07) days respectively;(7.82±3.09) days,(6.62±1.97) days,(6.72±4.20) days,(4.91± 3.07) days and(5.17± 2.91) days respectively in the control group. The total effective rate of the treatment group was 92.00%,and that of the control group was 72.00%.All above indexes showed statistical differences between the two groups(P<0.05).ConclusionRoutine treatment plus a short time of Pulmicort respulas administration could shorten the treatment course,improve lung function and ameliorate the therapeutic effect of severe MPP.
引文
1朱影,刘晓琳,叶玉兰.肺炎支原体所致大叶性肺炎46例临床分析[J].中华全科医学,2012,10(4):446-447.
2 陈进喜,刘志刚,林业辉,等.幼儿重症肺炎支原体肺炎的肺功能研究[J].黑龙江医药,2016,29(5):848-850.
3 You SY,Jwa HJ,Yang EA,et al.Effects of methylprednisolone pulse therapy on refractory Mycoplasma pneumonia pneumonia in children[J].Allergy Asthma Immunol Res,2014,6(1):22-26.
4 赵顺英,马云,张桂芳,等.儿童重症肺炎支原体肺炎11例临床分析[J].中国实用儿科杂志,2003,18(7):414-416.
5 俞珍惜,刘秀云,彭芸,等.儿童重症肺炎支原体肺炎的临床特点及预后[J].临床儿科杂志,2011,8(29):715-719.
6 葛柳源,任少敏.小儿重症肺炎支原体肺炎临床相关因素分析[J].内蒙古医学杂志,2017,49(6):672-674.
7 罗敏,邓瑜琼,刘沧海,等.儿童重症肺炎支原体肺炎18例临床诊断和治疗[J].中国当代医药,2014,21(1):182-184.
8 刘茂花,刘成军,于凤飞,等.喜炎平联合阿奇霉素治疗儿童重症肺炎支原体肺炎疗效观察[J].儿科药学杂志,2017,23(12):26-29.
9 韩娟.普米克令舒吸入联合阿斯美治疗感染后咳嗽的效果[J].中国医药导报,2017,14(3):152-155.
10 业晓青,张小兰,陈双雯,等.普米克令舒雾化吸入辅助治疗肺炎支原体下呼吸道感染的研究[J].中华医院感染学杂志,2014,24(22):5676-5677,5680.
11 江载芳,申昆玲,沈颖.诸福棠实用儿科学[J].8版.北京:人民卫生出版社,2015.
12 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(试行)(上)[J].中华儿科杂志,2007,45(2):86-86.
13 户波,毋英超.普米克令舒联合阿奇霉素治疗102例儿童肺炎支原体感染的疗效观察[J].中国医药创新,2015,12(4):38-40.
14 Inamura N,Miyashita N,Haseqawa S,et al.Management of refractory Mycoplasma pneumoniae pneumonia:utility of measuring serum lactate dehydrogenase level[J].J Infect Chemother,2014,20(4):270-273.
15 Izumikawa K,Izumikawa K,Takazono T,et al.Clinical features,risk factors and treatment of fulminant Mycoplasma pneumoniae pneumonia:a review of the Japanese literature[J].J Infect Chemother,2014,20(3):181-185.
16 鲍芳,曲久鑫,刘振嘉,等.儿童大环内酯耐药支原体肺炎的临床特点及治疗转归[J].中华结核和呼吸杂志,2013,36(10):756-761.
17 辛德莉,马红秋.难治性肺炎支原体肺炎的发病机制[J].实用儿科临床杂志,2012,27(4):233-234.
18 刘颖.儿童重症肺炎支原体肺炎相关危险因素研究[J].吉林医学,2017,38(8):1508-1509.
19 张健,陆峰,何敏,等.儿童肺炎支原体肺炎合并胸腔积液45例临床分析[J].临床儿科杂志,2013,31(8):796-796.
20 施敦翌,徐健.阿奇霉素联合红霉素治疗小儿支原体肺炎临床分析[J].医学综述,2015,21(22):4164-4165.
21 徐卫芹,韦国玉,何浩明.阿奇霉素联合热毒宁治疗小儿支原体肺炎的疗效观察[J].转化医学电子杂志,2015,2(3):46-47.
22 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.
23 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.
24 杨立新.红霉素联合阿奇霉素序贯疗法与单用阿奇霉素治疗小儿支原体肺炎的效果比较[J].中国医药导报,2016,13(18):173-176.
25 宋志芳.普米克令舒辅助治疗儿童肺炎支原体感染疗效观察[J].中国现代药物应用,2010,4(14):25-26.
26 朱晓霞.氧气雾化吸入自拟中药方汤剂治疗毛细支气管炎临床研究[J].现代医院,2015,15(4):71-72.
27 吴跃进,孙节,张建华,等.糖皮质激素辅助治疗儿童肺火支原体大叶性肺炎的疗效[J].中国当代儿科杂志,2014,16(4):401-405.
28 吴良霞,吴珉,顾丹萍.节段性肺炎支原体肺炎患儿肺功能检测的临床意义[J].中国当代儿科杂志,2011,13(3):185-187.
29 刘晶晶,李庆彦,管珊,等.慢性乙型肝炎患者中IL-37的水平与HBe Ag血清转换的关系研究[J].中国免疫学杂志,2015,21(11):1545-1548,1552.
30 聂红明,汪蓉,朱梅萍,等.不同临床状态的HBV感染相关肝病患者T淋巴细胞水平和主要细胞因子表达的比较[J].中西医结合肝病杂志,2015,25(1):8-12.
2 陈进喜,刘志刚,林业辉,等.幼儿重症肺炎支原体肺炎的肺功能研究[J].黑龙江医药,2016,29(5):848-850.
3 You SY,Jwa HJ,Yang EA,et al.Effects of methylprednisolone pulse therapy on refractory Mycoplasma pneumonia pneumonia in children[J].Allergy Asthma Immunol Res,2014,6(1):22-26.
4 赵顺英,马云,张桂芳,等.儿童重症肺炎支原体肺炎11例临床分析[J].中国实用儿科杂志,2003,18(7):414-416.
5 俞珍惜,刘秀云,彭芸,等.儿童重症肺炎支原体肺炎的临床特点及预后[J].临床儿科杂志,2011,8(29):715-719.
6 葛柳源,任少敏.小儿重症肺炎支原体肺炎临床相关因素分析[J].内蒙古医学杂志,2017,49(6):672-674.
7 罗敏,邓瑜琼,刘沧海,等.儿童重症肺炎支原体肺炎18例临床诊断和治疗[J].中国当代医药,2014,21(1):182-184.
8 刘茂花,刘成军,于凤飞,等.喜炎平联合阿奇霉素治疗儿童重症肺炎支原体肺炎疗效观察[J].儿科药学杂志,2017,23(12):26-29.
9 韩娟.普米克令舒吸入联合阿斯美治疗感染后咳嗽的效果[J].中国医药导报,2017,14(3):152-155.
10 业晓青,张小兰,陈双雯,等.普米克令舒雾化吸入辅助治疗肺炎支原体下呼吸道感染的研究[J].中华医院感染学杂志,2014,24(22):5676-5677,5680.
11 江载芳,申昆玲,沈颖.诸福棠实用儿科学[J].8版.北京:人民卫生出版社,2015.
12 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(试行)(上)[J].中华儿科杂志,2007,45(2):86-86.
13 户波,毋英超.普米克令舒联合阿奇霉素治疗102例儿童肺炎支原体感染的疗效观察[J].中国医药创新,2015,12(4):38-40.
14 Inamura N,Miyashita N,Haseqawa S,et al.Management of refractory Mycoplasma pneumoniae pneumonia:utility of measuring serum lactate dehydrogenase level[J].J Infect Chemother,2014,20(4):270-273.
15 Izumikawa K,Izumikawa K,Takazono T,et al.Clinical features,risk factors and treatment of fulminant Mycoplasma pneumoniae pneumonia:a review of the Japanese literature[J].J Infect Chemother,2014,20(3):181-185.
16 鲍芳,曲久鑫,刘振嘉,等.儿童大环内酯耐药支原体肺炎的临床特点及治疗转归[J].中华结核和呼吸杂志,2013,36(10):756-761.
17 辛德莉,马红秋.难治性肺炎支原体肺炎的发病机制[J].实用儿科临床杂志,2012,27(4):233-234.
18 刘颖.儿童重症肺炎支原体肺炎相关危险因素研究[J].吉林医学,2017,38(8):1508-1509.
19 张健,陆峰,何敏,等.儿童肺炎支原体肺炎合并胸腔积液45例临床分析[J].临床儿科杂志,2013,31(8):796-796.
20 施敦翌,徐健.阿奇霉素联合红霉素治疗小儿支原体肺炎临床分析[J].医学综述,2015,21(22):4164-4165.
21 徐卫芹,韦国玉,何浩明.阿奇霉素联合热毒宁治疗小儿支原体肺炎的疗效观察[J].转化医学电子杂志,2015,2(3):46-47.
22 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.
23 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.
24 杨立新.红霉素联合阿奇霉素序贯疗法与单用阿奇霉素治疗小儿支原体肺炎的效果比较[J].中国医药导报,2016,13(18):173-176.
25 宋志芳.普米克令舒辅助治疗儿童肺炎支原体感染疗效观察[J].中国现代药物应用,2010,4(14):25-26.
26 朱晓霞.氧气雾化吸入自拟中药方汤剂治疗毛细支气管炎临床研究[J].现代医院,2015,15(4):71-72.
27 吴跃进,孙节,张建华,等.糖皮质激素辅助治疗儿童肺火支原体大叶性肺炎的疗效[J].中国当代儿科杂志,2014,16(4):401-405.
28 吴良霞,吴珉,顾丹萍.节段性肺炎支原体肺炎患儿肺功能检测的临床意义[J].中国当代儿科杂志,2011,13(3):185-187.
29 刘晶晶,李庆彦,管珊,等.慢性乙型肝炎患者中IL-37的水平与HBe Ag血清转换的关系研究[J].中国免疫学杂志,2015,21(11):1545-1548,1552.
30 聂红明,汪蓉,朱梅萍,等.不同临床状态的HBV感染相关肝病患者T淋巴细胞水平和主要细胞因子表达的比较[J].中西医结合肝病杂志,2015,25(1):8-12.