摘要
目的探讨阿奇霉素序贯疗法对小儿支原体肺炎炎性因子及体液免疫功能调节的影响。方法选取2014年1月至2015年1月广饶县中医院收治的支原体肺炎患儿120例,采用随机数字表分为观察组和对照组,各60例。观察组患儿采用阿奇霉素序贯疗法进行治疗,首先使用阿奇霉素10 mg/kg静脉滴注,使用4 d左右,直至患儿体温、白细胞计数正常,后使用阿奇霉素干混悬剂10 mg/(kg·d)口服,使用3 d,停用4 d,再次口服阿奇霉素干混悬剂10 mg/(kg·d),使用3 d,共3个周期;对照组采用阿奇霉素静脉滴注治疗,静脉注射溶解于葡萄糖中的10 mg/(kg·d)的同浓度阿奇霉素溶液,1次/d,1周为1个疗程,共2个疗程。对两组患儿的疗效、炎性因子、体液免疫及不良反应进行评价。结果观察组总有效率显著高于对照组[96.7%(58/60)比75.0%(45/60)],差异有统计学意义(P<0.05)。治疗后4 d、12 d,两组患儿血清白细胞介素(IL)4、IL-6、IL-10、肿瘤坏死因子α、干扰素γ均呈下降趋势,且观察组低于对照组(P<0.01)。治疗后4 d、12 d,两组CD+3、CD+4呈上升趋势,观察组高于对照组;两组CD+8呈下降趋势,且观察组低于对照组(P<0.05)。观察组住院时间显著短于对照组[(7.3±1.2)d比(11.3±1.8)d],差异有统计学意义(P<0.01)。观察组皮疹、局部疼痛、胃肠道反应、丙氨酸转氨酶增加的发生率均显著低于对照组[13.3(8/60)比1.7%(1/60),20.0%(12/60)比3.3%(2/60),20.0%(12/60)比6.7%(4/60),10.0%(6/60)比0%,3.3(2/60)比0%],差异有统计学意义(P<0.05或P<0.01)。结论阿奇霉素序贯疗法有助于小儿支原体肺炎病情的稳定及恢复,缩短住院及症状体征消失时间,降低不良反应发生率,值得临床推广应用。
Objective To investigate the effect of azithromycin sequential therapy on proinflammatory cytokines and immune function in children with mycoplasma pneumonia. Methods A total of 120 children with mycoplasma pneumonia admitted to Guangrao County TCM Hospital included,and randomly divided into observation group and control group,60 cases in each group. The observation group was treated with azithro-mycin sequential therapy,10 mg/kg intravenous drip,for about 4 dtill the body temperature,white blood cell count was normal,then 10 mg/（ kg·d） oral azithromycin was given,3 d as a cycle,altogether 3 cycles. The control group was treated with intravenous infusion of azithromycin,intravenous injection of 10 mg/（ kg·d） in the glucose solution,1 h/d for 1 week,1 week as a cycle,altogether 2 cycles. The effect,the inflammatory cytokines,immune function and adverse reactions of the two groups were evaluated. Results The total effec-tive rate of the observation group was significantly higher than that of the control group [96. 7%（58/60） vs 75.0%（45/60）,P〈0.05]. After the treatment of 4 d,12 d,serum interleukin（IL） 4,IL-6,IL-10,tumor necrosis factor α and interferonγof the two groups were decreased,and the observation group was lower than that in the control group（P〈0. 01）. After the treatment of 4 d,12 d,CD3 ＋,CD4 ＋ of the two groups were increased, and the observation group was higher than the control group;CD8 ＋ of the two groups were decreased,and the observation group was lower than the control group（P〈0. 05）. The hospitalization time in the observation group was significantly lower than the control group[（7.3 ±1.2） d vs （11.3 ±1.8） d],the difference was statistically significant（P 〈0. 01）. The incidence of skin rash,local pain,gastrointestinal reaction,and the increase of alanine aminotransferase of the observation group were significantly lower than the control group[13. 3（8/60） vs 1. 7%（1/60）,20. 0%（12/60） vs 3. 3%（2/60）,20. 0%（12/60） vs 6. 7%（4/60）,10. 0%（6/60） vs 0%,3. 3%（2/60） vs 0%,P〈0. 05 or P〈0. 01]. Conclusion The application of azithromycin sequential therapy is helpful to the stabilization and recovery of mycoplasma pneu-monia in children,which can reduce hospitalization and symptoms disappearing time,reduce the incidence of adverse reactions,thus is worthy of clinical application.
出处
《医学综述》
2015年第19期3628-3630,共3页
Medical Recapitulate
关键词
小儿支原体肺炎
阿奇霉素
序贯疗法
炎性因子
体液免疫
Children with mycoplasma pneumonia navigation
Azithromycin
Sequential therapy
Proinflammatory cytokines
Humoral immunity
