| 摘要: |
| 目的:探讨地塞米松与甲泼尼龙治疗儿童难治性肺炎支原体肺炎( RMPP) 的临床疗效及安全性差异。方法:128 例
RMPP 患儿按随机数表法分为A 组(63 例) 和B 组(65 例)。在常规治疗基础上,A 组给予地塞米松0. 35 mg/ ( kg·d),每日
1 次静脉滴注,B 组给予甲泼尼龙2 mg/ (kg·d),每日2 次静脉滴注,疗程均为5 d,比较两组患儿治疗总有效率、临床症状改善
情况、血浆心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、
白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)]及药物不良反应发生情况。结果:B 组总有效率为86. 15%,高于A 组的71. 43%(P<
0. 05)。B 组患儿体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间和X 线胸片肺部阴影消失时间分别为(4. 55±1. 05) d、
(6. 67±1. 12)d、(10. 76±1. 47)d 和(7. 97±1. 03)d,短于A 组的(5. 24±1. 42)d、(7. 23±1. 57)d、(11. 63±2. 52)d 和(8. 43±1. 26)d,差
异均有统计学意义(P 均<0. 05)。治疗后,两组患儿CK、CK-MB、LDH、TNF-α、IL-6 和IFN-γ 水平均低于治疗前( P<0. 05),且
B 组降低幅度更大(P<0. 05)。A 组不良反应发生率为22. 22%,高于B 组的9. 23%(P<0. 05)。结论:甲泼尼龙治疗儿童RMMP
的临床疗效和安全性均优于地塞米松。 |
| 关键词: 地塞米松 甲泼尼龙 难治性肺炎支原体肺炎 儿童 疗效 安全性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2023.04.011 |
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| 基金项目: |
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| Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia |
| He Yang1, Gao Rongrong1, Song Shiqing2, Lyu Xiaoqian1, Ma Zhongzheng1, Yin Zhanru1 |
| ((1. Hengshui People’ s
Hospital, Hebei Hengshui 053000, China; 2. Shenzhou People’s Hospital, Hebei Shenzhou 053800, China)) |
| Abstract: |
| Objective: To observe the difference of clinical efficacy and safety of dexamethasone vs. methylprednisolone in the treatment
of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 128 children with RMPP were randomly
divided into group A (n =63) and group B (n =65). On the basis of conventional treatment, group A was given dexamethasone 0. 35
mg/ (kg·d), intravenously once a day, and group B was given methylprednisolone 2 mg/ (kg·d), 2 times a day for intravenous drip.
Two groups were both treated for 5 days. The clinical efficacy, improvement of clinical symptoms, plasma myocardial enzyme profile
such as creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), serum inflammatory factors such
as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and gamma-interferon (IFN-γ) and adverse drug reactions between the two
groups were compared. Results: The total effective rate in group B was 86. 15%, which was higher than that in group A (71. 43%) (P<
0. 05). Time that symptoms disappeared of group B was much shorter than that in group A, such as fever (4. 55 ±1. 05) d vs. (5. 24±
1. 12) d, cough (6. 67±1. 12) d vs. (7. 23±1. 57) d, lung rales (10.76±1.47) d vs. (11.63±2.52) d and X-ray lung shadow (7.97±
1. 03) d vs. (8. 43±1. 26) d, and the differences were all statistically significant (all P<0. 05). After treatment, the levels of CK,
CK-MB, LDH, TNF-α, IL-6 and IFN-γ of the two groups were all decreased compared with before treatment (P <0. 05), and the
decrease in group B was more significant than that in group A (P<0. 05). The incidence of adverse drug reactions in group A was
22. 22%, which was higher than 9. 23% in group B (P<0. 05). Conclusion: The results of this study show that methylprednisolone is
better than dexamethasone in clinical efficacy and safety in children with RMPP. |
| Key words: dexamethasone methylprednisolone refractory Mycoplasma pneumoniae pneumonia children efficacy safety |
