2020 年第 2 期 第 15 卷

阿奇霉素对支原体肺炎患儿症状改善及预后的影响

Effect of azithromycin on symptom recovery and prognosis in children with mycoplasma pneumonia

作者：王亚军1朱春梅1李光璞1刘伟杰2

英文作者：

单位：1首都儿科研究所呼吸内科，北京100020;2首都儿科研究所检验科，北京100020

英文单位：

关键词：支原体肺炎；阿奇霉素；儿童；症状改善

英文关键词：

• 摘要：

• 【摘要】目的    探讨阿奇霉素治疗支原体肺炎对患儿症状改善以及预后的影响。方法    选取2017年5月至2018年6月在首都儿科研究所接受治疗的支原体肺炎患儿104例。采用随机数字表法将患儿分为对照组和观察组，各52例。在常规治疗基础上，对照组给予注射用乳糖红霉素治疗，观察组给予注射用阿奇霉素治疗，比较2组患儿治疗后退热时间、止咳时间、头痛消失时间、抗菌药物治疗时间以及住院时间，记录2组患儿治疗前后CRP水平，对比分析2组治疗后不良反应发生率以及临床效果。结果    治疗后，观察组患儿的退热时间、止咳时间、头痛消失时间、抗菌药物治疗时间以及平均住院时间均短于对照组［（3.1±0.4）d比（4.9±0.9）d、（4.6±1.0）d比（6.9±1.2）d、（3.2±0.9）d比（6.2±1.6）d、（6.0±1.2）d比（9.0±1.3）d、（8.7±1.5）d比（12.6±2.0）d］，差异均有统计学意义（均P<0.05）。治疗前，观察组与对照组患儿的CRP水平比较差异无统计学意义（P>0.05）。治疗后，观察组与对照组患儿的CRP水平均低于治疗前，且观察组低于对照组，差异均有统计学意义（均P<0.05）。治疗结束后，2组患儿均有腹泻、恶心、肝功能损伤以及局部红肿等不良反应出现，观察组总发生率低于对照组［15.4%（8/52）比32.7%（17/52）］，差异有统计学意义（P<0.05）。观察组治疗后的总有效率高于对照组［96.2%（50/52）比73.1%（38/52）］，差异有统计学意义（P<0.05）。结论    阿奇霉素可有效改善支原体肺炎患儿的临床症状，降低CRP水平，降低不良反应发生率且安全性良好，效果显著。

• 【Abstract】Objective    To investigate the effect of azithromycin on symptom recovery and prognosis of mycoplasma pneumonia in children. Methods    A total of 104 children with mycoplasma pneumonia admitted to Capital Institute of Pediatrics from May 2017 to June 2018 were randomly divided into control group and observation group, with 52 cases in each group. The control group was treated with erythromycin lactobionate injection and the observation group was treated with azithromycin injection. Defervescence time, cough relieving time, headache recovery time, antibiotic treatment time and hospitalization time were recorded. Serum C-reactive protein（CRP） levels before and after treatment, adverse reactions and clinical efficacy were analyzed. Results    After treatment, defervescence time, cough relieving time, headache recovery time, antibiotic treatment time and hospitalization time in observation group were significantly shorter compared with those in control group［（3.1±0.4）d vs （4.9±0.9）d, （4.6±1.0）d vs （6.9±1.2）d, （3.2±0.9）d vs （6.2±1.6）d, （6.0±1.2）d vs （9.0±1.3）d, （8.7±1.5）d vs （12.6±2.0）d,］(all P<0.05). There was no statistical difference in serum CRP level between groups before treatment(P>0.05). After treatment, serum CRP level significantly decreased and it was lower in observation group than that in control group(all P<0.05). Incidence of adverse reactions（diarrhea, nausea, liver function damage and local swelling） in observation group was significantly lower than that in control group［15.4%(8/52) vs 32.7%(17/52)］(P<0.05). The total effective rate in observation group was significantly higher than that in control group［96.2%(50/52) vs 73.1%(38/52)］(P<0.05). Conclusion    Azithromycin treating mycoplasma pneumonia in children can effectively improve clinical symptoms and reduce CRP level; the adverse reactions are tolerable.