阿奇霉素联合小剂量糖皮质激素对儿童大叶性肺炎炎症相关指标影响分析

发布时间：2018-01-30 17:22

本文关键词： 阿奇霉素小剂量糖皮质激素儿童大叶性肺炎临床疗效炎症　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的观察阿奇霉素联合小剂量糖皮质激素对儿童大叶性肺炎炎症相关指标的影响。方法选取医院儿科门诊或病房收治的确诊为大叶性肺炎的患儿88例,依据治疗方案的不同将患儿分为观察组与对照组,每组各44例;对照组予口服阿奇霉素治疗,观察组在对照组治疗基础上予静脉滴注甲泼尼龙琥珀酸钠治疗,21d后观察两组患儿临床疗效、身体特征改善情况及治疗前后外周血白细胞计数、血沉、超敏C-反应蛋白改善情况。结果观察组患儿总有效率为90.91%,对照组为65.91%,观察组患儿的总有效率显著高于对照组(χ2=8.12,P0.05);治疗后,观察组患儿咳嗽持续时间(6.00±1.63)d、退热时间(6.03±1.59)d及肺部体征消失时间(9.15±1.42)d,对照组患儿咳嗽持续时间(9.13±2.09)d、退热时间(7.28±2.07)d及肺部体征消失时间(10.29±2.17)d;观察组均短于对照组,差异有统计学意义(P0.05);治疗前观察组患儿白细胞、超敏C-反应蛋白、血沉指标水平分别为(12.37±8.89)×109/L、(17.51±6.11)mg/L、(38.72±5.89)mm/h,对照组为(12.39±9.06)×109/L、(17.45±5.93)mg/L、(39.61±5.71)mm/h,两组比较差异无统计学意义;治疗后观察组患儿白细胞、超敏C-反应蛋白、血沉指标水平分别为(10.57±7.02)×109/L、(6.01±1.26)mg/L、(20.71±4.05)mm/h,均低于治疗前,差异有统计学意义(P0.05);对照组为(10.92±8.13)×109/L、(8.08±2.04)mg/L、(23.15±4.62)mm/h,表达均低于治疗前;治疗后两组患儿白细胞水平差异无统计学意义,观察组患儿hs-CRP、血沉水平低于对照组,差异有统计学意义(P0.05)。结论阿奇霉素联合小剂量糖皮质激素治疗儿童大叶性肺炎疗效确切,能够缓解疾病症状,改善体内炎症反应,缩短病程,值得在临床推广应用。
[Abstract]:Objective to observe the effect of azithromycin combined with low dose glucocorticoid on inflammatory indexes in children with lobar pneumonia. The children were divided into observation group and control group according to the treatment plan, 44 cases in each group. The control group was treated by oral azithromycin, the observation group was treated with methylprednisolone sodium succinate on the basis of the control group, and the clinical effect of the two groups was observed after 21 days. The improvement of body characteristics and peripheral blood leukocyte count, ESR, hypersensitive C-reactive protein were improved before and after treatment. Results the total effective rate was 90.91 in the observation group and 65.91% in the control group. The total effective rate in the observation group was significantly higher than that in the control group (蠂 ~ 2 = 8.12, P 0.05). After treatment, the duration of cough was 6.00 卤1.63 days, the time of antipyretic was 6.03 卤1.59g / d and the time of lung signs disappeared was 9.15 卤1.42 days. In the control group, the duration of cough was 9.13 卤2.09 days, the time of antipyretic was 7.28 卤2.07 and the time of disappearance of pulmonary signs was 10.29 卤2.17 days. The observation group was shorter than the control group, and the difference was statistically significant (P 0.05). The levels of leukocyte, hypersensitive C-reactive protein and ESR in the observation group were 12.37 卤8.89 脳 10 9 / L and 17.51 卤6.11 mg / L respectively. 38.72 卤5.89 mm / h in the control group and 17.45 卤5.93 mg / L in the control group (12.39 卤9.06) 脳 10 ~ 9 / L 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) ~ (-1). 39.61 卤5.71 mm / h, there was no significant difference between the two groups. After treatment, the levels of leukocytes, hypersensitive C-reactive protein and ESR in the observation group were 10.57 卤7.02 脳 10 9 / L and 6.01 卤1.26 mg / L, respectively. The difference was statistically significant (P 0.05) between the two groups (20.71 卤4.05 mm / h, P < 0.05). In the control group, the expression of 10.92 卤8.13 脳 10 ~ (9) 脳 10 ~ (9) 路L ~ (-1) 路L ~ (-1) mg 路L ~ (-1) 路L ~ (-1) C was 23.15 卤4.62 mm / h, which was lower than that before treatment. After treatment, there was no significant difference in leukocyte level between the two groups. The levels of hs-CRP and ESR in the observation group were lower than those in the control group. Conclusion Azithromycin combined with low-dose glucocorticoid is effective in the treatment of children with lobar pneumonia, which can alleviate the symptoms of the disease, improve the inflammatory reaction in vivo and shorten the course of disease. It is worth popularizing in clinic.
【作者单位】：眉山市人民医院儿内科;
【基金】：四川省卫生厅基金资助项目(1902723)
【分类号】：R725.6
【正文快照】： 肺炎是儿科常见疾病,流行病学调查研究显示,全球范围内每年约有1.55亿儿童感染肺炎,7%~13%的感染患儿需住院接受治疗[1]。大叶性肺炎是指由各种病原体感染所引起的急性肺组织炎症,病变部位多分布于一个肺段以上的肺组织,可为大叶性,也可为节段性。该病全年散发,冬季及春季发病

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