2021 年第 5 期 第 16 卷

甲泼尼龙联合肺泡灌洗治疗肺炎支原体肺炎的效果及对患儿乳酸脱氢酶和高敏C反应蛋白水平的影响

Therapeutic effect of methylprednisolone combined with alveolar lavage on children with mycoplasma pneumoniae pneumonia and its influence on the levels of lactate dehydrogenase and high-sensitivity C-reactive protein

作者：胡彩云姜家利徐卫华张琪

英文作者：Hu Caiyun Jiang Jiali Xu Weihua Zhang Qi

单位：安徽省儿童医院急诊科，合肥230001

英文单位：Department of Emergency Anhui Provincial Children′s Hospital Hefei 230001 China

关键词：肺炎支原体肺炎；甲泼尼龙；肺泡灌洗；乳酸脱氢酶；高敏C反应蛋白

英文关键词：Mycoplasmapneumoniaepneumonia;Methylprednisolone;Alveolarlavage;Lactatedehydrogenase;High-sensitivivityC-reactiveprotein

• 摘要：

• 目的 观察甲泼尼龙联合肺泡灌洗治疗肺炎支原体肺炎（MPP）的效果及对患儿乳酸脱氢酶（LDH）和高敏C反应蛋白（hs-CRP）水平的影响。方法 选取2018年9月至2020年9月安徽省儿童医院临床确诊的MPP患儿100例，采用随机数字表法分为对照组、观察组，各50例。对照组在常规治疗基础上采用肺泡灌洗技术进行治疗，观察组在对照组的基础上静脉滴注甲泼尼龙进行治疗。比较2组患儿临床症状体征改善情况、肺功能及白细胞介素8（IL-8）、乳酸脱氢酶（LDH）、γ干扰素、hs-CRP水平，比较治疗效果及不良反应发生情况。结果 观察组咳嗽消失时间、发热消退时间、X线胸片恢复正常时间、肺部症状消失时间均短于对照组，差异均有统计学意义（均P＜0.05）。治疗后2组患儿用力肺活量占预计值百分比、呼气峰值流速占预计值百分比、最大呼气中段流速占预计值百分比均高于治疗前，且观察组高于对照组，差异均有统计学意义（均P＜0.05）。治疗后2组患儿IL-8、LDH、γ干扰素、hs-CRP水平均低于治疗前，且观察组低于对照组［（13±4）ng/L比（26±4）ng/L、（188±42）U/L比（252±41）U/L、（517±37）ng/L比（698±42）ng/L、（1.45±0.12）mg/L比（2.46±0.24）mg/L］，差异均有统计学意义（均P＜0.05）。观察组总有效率高于对照组［98.0%（49/50）比82.0%（41/50）］，差异有统计学意义（χ2=8.400，P=0.004）。2组总不良反应发生率比较差异无统计学意义（χ2=0.792，P=0.374）。结论 甲泼尼龙联合肺泡灌洗能够有效改善MPP患儿肺功能及炎性因子表达水平。

• Objective To observe the therapeutic effect of methylprednisolone combined with alveolar lavage on children with mycoplasma pneumoniae pneumonia(MPP) and its influence on the levels of lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (hs-CRP). Methods From September 2018 to September 2020, 100 children with MPP diagnosed in Anhui Provincial Children′s Hospital were selected. They were randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with alveolar lavage on the basis of conventional treatment, and the observation group was treated with methylprednisolone intravenous drip on the basis of the control group. The improvement of clinical symptoms and signs, pulmonary function and levels of interleukin-8(IL-8), LDH, interferon-γ and hs-CRP were compared between the two groups, and the treatment effect and adverse reactions were compared. Results The cough disappearance time, fever regression time, chest X-ray recovery time and lung symptom disappearance time in the observation group were shorter than those in the control group, and the differences were statistically significant(all P<0.05). After treatment, the percentage of forced vital capacity to predicted value, peak expiratory flow rate to predicted value and maximum mid-expiratory flow rate to predicted value in two groups were higher than those before treatment, and those in the observation group were higher than those in the control group, and the differences were statistically significant(all P<0.05). After treatment, the levels of IL-8, LDH, interferon-γ and hs-CRP in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group［(13±4)ng/L vs (26±4)ng/L, (188±42)U/L vs (252±41)U/L, (517±37)ng/L vs (698±42)ng/L, (1.45±0.12)mg/L vs (2.46±0.24)mg/L］(all P<0.05). The total effective rate of the observation group was higher than that of the control group［98.0%(49/50) vs 82.0%(41/50)］(χ2=8.400， P=0.004). There was no significant difference in the incidence of adverse reactions between the two groups（χ2=0.792, P=0.374）. Conclusion Methylprednisolone combined with alveolar lavage can effectively improve the lung function and the expressions of inflammatory factors in children with MPP.