| 摘要: |
| 目的:分析多西环素联合甲泼尼龙治疗儿童难治性肺炎支原体肺炎(RMPP)的临床疗效,探究其对患儿血清炎症因子、T
淋巴细胞亚群的影响。 方法:选择 2023 年 3 月至 2024 年 3 月我院住院治疗的 RMPP 患儿 60 例,采用随机数表法分为对照组和
观察组各 30 例。 患儿入院后均接受止咳、化痰等对症治疗,对照组在常规对症治疗基础上采用阿奇霉素联合甲泼尼龙方案治
疗,观察组在常规对症治疗基础上采用多西环素联合甲泼尼龙方案治疗。 观察两组临床疗效和症状改善时间,比较两组血清炎
症因子、T 淋巴细胞亚群指标及不良反应。 结果:观察组的总有效率为 93. 33%(28/ 30) 高于对照组的 63. 33% (19/ 30) (P<
0. 05);观察组体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间、影像学恢复正常时间均短于对照组(P<0. 05);治疗后,两
组血清肿瘤坏死因子(TNF)-α、超敏 C 反应蛋白(hs-CRP)、白细胞(WBC)均低于治疗前,且观察组均低于对照组(P<0. 05);治
疗后,两组 T 细胞亚群指标 CD3
+、CD4
+、CD4
+ / CD8
+高于治疗前,CD8
+ 低于治疗前,且观察组均优于对照组(P<0. 05);两组不
良反应(皮疹、恶心、呕吐、腹痛和腹泻等)发生率比较差异无统计学意义(P>0. 05)。 结论:多西环素联合甲泼尼龙能够改善
RMPP 患儿血清炎症因子、T 淋巴细胞亚群指标,缩短肺炎症状时间,具有良好的临床疗效和安全性。 |
| 关键词: 多西环素 甲泼尼龙 难治性肺炎支原体肺炎 炎症因子 T 淋巴细胞亚群 不良反应 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.09.006 |
|
| 基金项目: |
|
| EfficacyofDoxycyclineCombinedwithMethylprednisoloneintheTreatmentofRefractoryMycoplasmaPneumoniaePneumonia |
| Shen
Guomei
1,2,
Hu
Wanjian
2,
Jia
Shuwen
2 |
| (1.
Zhejiang
University
of
Chinese
Medicine,
Hangzhou
310000,
China;
2.
Hangzhou
Linping
District
Maternal
and
Child
Health
Hospital,
Hangzhou 311199,
China) |
| Abstract: |
| Objective:
To
analyze
the
clinical
efficacy
of
doxycycline
combined
with
methylprednisolone
in
the
treatment
of
refractory
Mycoplasma
pneumoniae
pneumonia
in
children,
so
as
to
explore
its
effects
on
serum
inflammatory
factors
and
T
lymphocyte
subsets
in
children.
Methods:
Totally
60
children
with
refractory
M.
pneumoniae
pneumonia
admitted
into
our
hospital
from
Mar.
2023
to
Mar.
2024
were
extracted
to
be
divided
into
the
observation
group
and
control
group
via
the
random
number
table
method,
with
30
cases
in
each
group.
After
admission,
all
patients
were
given
conventional
symptomatic
treatment
such
as
relieving
cough
and
resolving
phlegm.
The
control
group
was
treated
with
azithromycin
combined
with
methylprednisolone
on
the
basis
of
conventional
treatment,
while
the
observation
group
received
doxycycline
combined
with
methylprednisolone
based
on
the
control
group.
The
clinical
efficacy
and
improvement
time
of
clinical
symptoms
between
two
groups
were
observed.
The
serum
inflammatory
factors,
T
lymphocyte
subsets
and
adverse
drug
reactions
of
two
groups
were
compared.
Results:
The
total
effective
rate
of
observation
group
was
93. 33%
(28/ 30),
higher
than
63. 33%
(19/ 30)
of
control
group
(P<0. 05).
The
duration
of
fever,
disappearance
time
of
cough
and
lung
rales,
recovery
time
of
imaging
in
the
observation
group
were
shorter
than
those
in
control
group
(P<0. 05).
After
treatment,
serum
levels
of
tumor
necrosis
factor
(TNF-α),
hypersensitive
C-reactive
protein
(hs-CRP)
and
white
blood
cell
(WBC)
in
two
groups
were
lower
than
those
before
treatment,
and
the
observation
group
was
lower
than
the
control
group
(P<0. 05).
After
treatment,
T
cell
subsets
CD3
+,
CD4
+,
CD4
+ / CD8
+
were
higher
than
those
before
treatment,
CD8
+
was
lower
than
that
before
treatment,
and
the
observation
group
was
better
than
the
control
group
(P< 0. 05).
There
was
no
statistically
significant
difference
in
the
incidence
of
adverse
drug
reactions
(rash,
nausea,
vomiting,
abdominal
pain
and
diarrhea )
between
two
groups
( P > 0. 05 ).
Conclusion:
Doxycycline
combined
with
methylprednisolone
can
improve
serum
inflammatory
factors
and
T
lymphocyte
subsets
in
children
with
refractory
M.
pneumoniae
pneumonia,
shorten
the
duration
of
pneumonia
symptoms,
with
significant
clinical
efficacy
and
safety. |
| Key words: doxycycline methylprednisolone refractory
Mycoplasma
pneumoniae
pneumonia inflammatory
factors T
lymphocyte
subsets adverse
drug
reactions |
