Efficacy of azithromycin combined with acetylcysteine alveolar lavage in the treatment of severe Mycoplasma pneumoniae pneumonia in children
-
摘要:目的
观察阿奇霉素联合乙酰半胱氨酸肺泡灌洗术对儿童重症肺炎支原体肺炎(SMPP)的临床疗效。
方法选取80例SMPP患儿作为研究对象，采用随机数字表法分为对照组和观察组，每组40例。对照组采用阿奇霉素注射液静脉滴注及其他一般对症治疗，疗程5 d; 观察组在对照组治疗基础上加用乙酰半胱氨酸肺泡灌洗术治疗，疗程5 d。比较2组患儿的临床疗效、实验室指标和肺功能指标。
结果治疗5 d后，观察组患儿的治疗总有效率高于对照组，差异有统计学意义(P < 0.05); 观察组患儿的发热持续时间和肺部湿啰音持续时间短于对照组，差异有统计学意义(P < 0.05); 治疗5 d后，2组患儿每公斤体质量潮气量(VT/kg)、呼气峰流速/呼气达峰时间(PTEF/TPTEF)、剩余25%潮气量时用力呼气流量(FEF25%)、剩余25%潮气量时呼气流速/呼气峰流速(25/PF)均高于治疗前，且观察组VT/kg、PTEF/TPTEF、TEF25%、25/PF高于对照组，差异有统计学意义(P < 0.05)。
结论阿奇霉素联合乙酰半胱氨酸肺泡灌洗术能有效改善SMPP患儿的临床疗效，缩短发热持续时间、肺部湿啰音持续时间，改善肺功能。
-
关键词:
- 重症肺炎支原体肺炎 /
- 乙酰半胱氨酸肺泡灌洗术 /
- 阿奇霉素 /
- 呼吸功能
Abstract:ObjectiveTo observe the clinical efficacy of azithromycin combined with acetylcysteine alveolar lavage in the treatment of severe Mycoplasma pneumoniae pneumonia (SMPP) in children.
MethodsA total of 80 children with SMPP were selected as study subjects and divided into control group and observation group using a random number table method, with 40 cases in each group. The control group was treated with intravenous drip of azithromycin injection and other general symptomatic treatments for 5 days. The observation group was treated with acetylcysteine alveolar lavage on the basis of the control group for 5 days. The clinical efficacy, laboratory indicators, and lung function indicators of the two groups were compared.
ResultsAfter 5 days of treatment, the total effective rate of treatment in the observation group was higher than that in the control group (P < 0.05). The duration of fever and lung moist rales in the observation group was shorter than that in the control group (P < 0.05). After 5 days of treatment, the tidal volume per kilogram of body mass (VT/kg), peak expiratory flow to peak expiratory time ratio (PTEF/TPTEF), forced expiratory flow at 25% residual tidal volume (FEF25%), and expiratory flow to peak expiratory flow ratio at 25% residual tidal volume (25/PF) of the two groups were higher than those before treatment, and VT/kg, PTEF/TPTEF, FEF25%, and 25/PF in the observation group were higher than those in the control group (P < 0.05).
ConclusionAzithromycin combined with acetylcysteine alveolar lavage can effectively improve the clinical efficacy of children with SMPP, shorten the duration of fever and lung moist rales, and improve lung function.
-
-
表 1 2组患儿临床疗效和临床指标比较(x±s)[n(%)]
指标 分类 对照组(n=40) 观察组(n=40) 临床疗效 显效 17(42.50) 22(55.00) 有效 12(30.00) 15(37.50) 无效 11(27.50) 3(7.50) 总有效 29(72.50) 37(92.50)* 发热持续时间/d 5.81±1.12 4.25±0.69* 肺部湿啰音持续时间/d 6.30±1.08 4.17±0.75* 与对照组比较, * P < 0.05。 
下载: 导出CSV
表 2 2组患儿肺功能指标比较(x±s)
指标 时点 对照组(n=40) 观察组(n=40) (VT/kg)/(mL/kg) 治疗前 6.23±1.54 6.15±1.70 治疗后 7.80±1.69* 9.64±2.15*# (PTEF/TPTEF)/(L/m2) 治疗前 0.46±0.21 0.35±0.16 治疗后 0.69±0.25* 0.71±0.35*# TEF25%/(mL/s) 治疗前 51.45±15.63 50.86±13.97 治疗后 55.09±12.86* 62.44±15.37*# (25/PF)/% 治疗前 54.35±15.73 55.81±15.04 治疗后 64.92±6.15* 73.66±7.82*# VT/kg: 每公斤体质量潮气量;
PTEF/TPTEF: 呼气峰流速/呼气达峰时间;
FEF25%: 剩余25%潮气量时用力呼气流量;
25/PF: 剩余25%潮气量时呼气流速/呼气峰流速。
与治疗前比较, * P < 0.05; 与对照组比较, #P < 0.05。
下载: 导出CSV
-
[1] 陈迎春. 小儿重症肺炎支原体肺炎的临床特点及诊治方案研究[J]. 当代医学, 2020, 26(3): 152-153. doi: 10.3969/j.issn.1009-4393.2020.03.066 [2] WANG Y C, WANG Y, JIAO W W, et al. Development of loop-mediated isothermal amplification coupled with nanoparticle-based lateral flow biosensor assay for Mycoplasma pneumoniae detection[J]. AMB Express, 2019, 9(1): 196. doi: 10.1186/s13568-019-0921-3
[3] HASHEMIAN H, ALIZADEH H, KAZEMNEJAD LEYLI E. Efficacy of zinc as adjuvant therapy in the treatment of severe pneumonia in hospitalized children: a randomized clinical trial[J]. Arch Pediatr Infect Dis, 2020, 9(1): 1-6.
[4] TONG L, HUANG S M, ZHENG C, et al. Refractory Mycoplasma pneumoniae pneumonia in children: early recognition and management[J]. J Clin Med, 2022, 11(10): 2824. doi: 10.3390/jcm11102824
[5] 黄斌. 射频电疗辅助乙酰半胱氨酸雾化治疗小儿肺炎的疗效观察[J]. 实用临床医药杂志, 2019, 23(21): 67-69. doi: 10.7619/jcmp.201921020 [6] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 7版. 北京: 人民卫生出版社, 2005: 1856-1856. [7] 中华医学会儿科学分会呼吸学组儿科支气管镜协作组. 儿科支气管镜术指南(2009年版)[J]. 中华儿科杂志, 2009, 47(10): 740-744. doi: 10.3760/cma.j.issn.0578-1310.2009.10.006 [8] 沈亚娟, 王金龙, 陈桂锋, 等. 儿童社区获得性肺炎临床特征与大环内酯类抗生素疗效分析[J]. 临床儿科杂志, 2013, 31(4): 331-334. doi: 10.3969/j.issn.1000-3606.2013.04.009 [9] 殷剑松, 万瑜, 张力文, 等. 肺炎支原体肺炎合并胸腔积液相关因素分析[J]. 实用临床医药杂志, 2021, 25(3): 54-58. doi: 10.7619/jcmp.20210049 [10] 曾令文, 邱冬梅, 王燕. 甲泼尼龙联合大环内酯类抗生素治疗小儿重症肺炎支原体肺炎的临床分析[J]. 当代医学, 2019, 25(15): 46-48. doi: 10.3969/j.issn.1009-4393.2019.15.016 [11] OKAZAKI N, NARITA M, YAMADA S, et al. Characteristics of macrolide-resistant Mycoplasma pneumoniae strains isolated from patients and induced with erythromycin in vitro[J]. Microbiol Immunol, 2001, 45(8): 617-620. doi: 10.1111/j.1348-0421.2001.tb01293.x
[12] 辛德莉, 韩旭, 李靖, 等. 肺炎支原体对大环内酯类抗生素的耐药分析[J]. 中国实用儿科杂志, 2006, 21(8): 616-617. doi: 10.3969/j.issn.1005-2224.2006.08.022 [13] 唐瑞琪, 黄英. 糖皮质激素在儿童难治性肺炎支原体肺炎中的应用[J]. 儿科药学杂志, 2016, 22(11): 56-58. https://www.cnki.com.cn/Article/CJFDTOTAL-EKYX201611020.htm [14] SHEN Y L, ZHANG J, HU Y H, et al. Combination therapy with immune-modulators and moxifloxacin on fulminant macrolide-resistant Mycoplasma pneumoniae infection: a case report[J]. Pediatr Pulmonol, 2013, 48(5): 519-522. doi: 10.1002/ppul.22650
[15] 路素坤, 牛波, 黄坤玲, 等. 儿童重症肺炎支原体肺炎形成原因分析[J]. 河北医药, 2023, 45(5): 704-706, 711. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ202305014.htm [16] 戴洪法, 廖翠乐, 米沛明. 纤维支气管镜下支气管肺泡灌洗在儿童重症肺炎支原体肺炎中的应用价值[J]. 中国医学创新, 2018, 15(12): 48-51. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYCX201812016.htm [17] 张智楠. 支气管肺泡灌洗技术在儿童重症肺炎支原体肺炎中的应用效果[J]. 中国当代医药, 2022, 29(32): 123-126. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD202232031.htm [18] DMYTRⅡEV D, NAZARCHUK O, BABINA Y. High-dose N-acetylcysteine therapy in the treatment of pneumonia[J]. Prmd, 2021, 4(1): 4-10.
[19] 符垂师, 黄惠敏, 李国雄, 等. 儿童肺炎支原体肺炎治愈1年内发生反复呼吸道感染的相关因素研究[J]. 传染病信息, 2020, 33(2): 144-146, 175. https://www.cnki.com.cn/Article/CJFDTOTAL-CRBX202002011.htm [20] MEYER SAUTEUR P M, THEILER M, BUETTCHER M, et al. Frequency and clinical presentation of mucocutaneous disease due to Mycoplasma pneumoniae infection in children with community-acquired pneumonia[J]. JAMA Dermatol, 2020, 156(2): 144-150.
-
期刊类型引用(2)
1. 欧冬冬. 乙酰半胱氨酸雾化联合罗红霉素分散片对重症支原体肺炎患儿的影响. 中外医学研究. 2025(05): 123-126 . 
百度学术
2. 姜秀明，李建卫. 乙酰半胱氨酸雾化吸入联合盐酸莫西沙星氯化钠注射治疗老年重症肺炎的效果观察. 中国药物滥用防治杂志. 2024(12): 2284-2285+2288 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 130
- HTML全文浏览量: 27
- PDF下载量: 7
- 被引次数: 2
苏公网安备 32100302010246号