| 摘要: |
| 目的:观察糖皮质激素辅助治疗儿童难治性肺炎支原体肺炎的临床疗效。方法:将136例难治性肺炎支原体肺炎患儿随机分为常规治疗组62例和激素治疗组74例,所有患儿均给予抗感染、退热、止咳、化痰等对症处理,激素治疗组在对症治疗基础上加用甲泼尼龙2 mg/(kg·d)静脉滴注,并逐渐减少激素用量。比较两组患儿临床症状体征、影像学指标、炎症指标改善情况。结果:激素治疗组退热时间、咳嗽基本消失时间、胸部X 线片肺部阴影吸收时间、肺部湿啰音吸收时间较常规治疗组明显缩短(P<0.05),血沉、快速C反应蛋白水平下降程度比常规治疗组更为显著(P<0.05),治疗有效率明显高于常规治疗组。结论:对于儿童难治性肺炎支原体肺炎,在大环内酯类抗生素基础上加用糖皮质激素治疗,能够更快缓解临床症状体征,促进肺部炎症吸收,减轻全身炎症反应。 |
| 关键词: 难治性 肺炎支原体肺炎 糖皮质激素 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.08.009 |
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| 基金项目: |
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| Effect of Therapy with Glucocorticoids in Children with Refractory Mycoplasma Pneumoniae Pneumonia |
| Liu Qing, Li Hu, Zhang Ling, Hua Yajun |
| (Jiangyin Hospital Affiliated to Medical School of Southeast University, Jangsu Jiangyin 214400, China) |
| Abstract: |
| Objective: To study the efficacy of therapy with glucocorticoids in children with refractory Mycoplasma pneumoniae pneumonia. Methods: One hundred and thirty six cases of children with refractory Mycoplasma pneumoniae pneumonia were randomly divided into routine treatment group (62 cases) and hormone treatment group (74 cases). The routine treatment group was given symptomatic treatment, the hormone treatment group was given methylprednisolone 2 mg/(kg·d) by intravenous drip and was gradually reduced on the basis of the routine treatment group. The clinical symptoms and signs, imaging and the improvement of inflammatory markers were compared between the two groups. Results: Compared with the routine treatment group, the duration of fever, cough relief time, pulmonary shadow absorption time on chest X-ray and pulmonary rale elimination time were significantly shorter in the hormone treatment group (P<0.05). Levels of serum CRP and ESR were reduced more in the hormone treatment group than in the routine treatment group (P<0.05). The hormone treatment acquired significantly higher effective rate than the routine treatment. Conclusion: Therapy with glucocorticoids in addition to macrolides antibiotics could more effectively alleviate clinical symptoms and signs, promote the absorption of pulmonary inflammation and relieve systemic inflammatory response in children with refractory Mycoplasma pneumoniae pneumonia. |
| Key words: refractory Mycoplasma pneumoniae pneumonia glucocorticoids children |
