阿奇霉素序贯疗法及红霉素治疗小儿支原体肺炎疗效比较.docVIP

阿奇霉素序贯疗法及红霉素治疗小儿支原体肺炎疗效比较 　 作者：高瑞宁，徐秀红，郭宇红 【摘要】 　　目的：探讨阿奇霉素序贯治疗小儿支原体肺炎的临床疗效。方法：采用随机对照分组研究方法，将80例患儿随机分为两组，阿奇霉素序贯治疗组40例，红霉素治疗组40例，比较两组的疗效及不良反应。结果：治疗组治愈率和总有效率分别为65.0%、95.0%，对照组治愈率和总有效率分别为47.5%、75.0%，治疗组优于对照组，但两组比较差异无统计学意义（P＞0.05）。治疗组退热时间、咳嗽好转时间、啰音消失时间及平均住院时间均较对照组缩短（P＜0.01），而且局部疼痛、胃肠道反应及肝功损伤程度明显降低（P＜0.05）。结论：阿奇霉素序贯治疗小儿支原体肺炎优于红霉素，具有起效快、疗效好、安全性高、不良反应少等优点，值得临床推广。　 【关键词】 阿奇霉素 红霉素 肺炎 支原体 　　Clinical Observation of Azithromycin Sequential Therapy in Treatment of Mycoplasmal Pneumonia in Children in Comparison with the Treatment of Erythromycin 　　［Abstract］ Objective:To evaluate the clinic curative effect of azithromycin sequential therapy on mycoplasmal pneumonia (MP) in children. Methods: We divided 80 MP children into azithromycin group (40 cases) and erythromycin group (40 cases) randomly, with their curative effects and adverse reactions compared. Results: The rates of healing and general efficiency for azithromycin group were 65.0% and 95.0% while 47.5% and 75.0% in the erythromycin group, and there was no difference between the two groups (P＞0.05). Time of pyretolysis, cough relief, hello lung sound disappearing and the mean length of hospitalization of the azithromycin sequential therapy group were shorter than those of the erythromycin group(P＜0.01). The local ache, stomach and intestinal tract adverse reaction, and damage of hepar function were less than those in the erythromycin group(P＜0.05). Conclusions: Azithromycin sequential therapy is better than erythromycin for MP children with a quicker and better effect, better safety and fewer adverse reaction etc. and worth promoting. 　　［Key words］ Azithromycin; Erythromycin; Pneumonia; Mycoplasmal 　　肺炎支原体（MP）是呼吸道感染的常见病原，约占小儿呼吸道感染病原的30%以上。近年来MP感染有逐年增加的趋势，对儿童健康造成严重危害。我院从2006年初对收治的40例MP患儿采用阿奇霉素序贯治疗并与红霉素进行对比研究，现将治疗结果结合文献复习报道如下： 　　1 资料与方法 　　1.1 一般资料 　　以我院儿科病房2006年2月至2008年6月收治的80例支原体肺炎儿童病例为研究对象，其症状、体征、胸部X线片、病原学检查均符合《诸福棠实用儿科学》第7版MP肺炎诊断标准［1］，排除肝脏疾病或肝功能异常、对大环内酯类药物过敏及需联合使用其他抗生素的患者。采用随机抽签方式分为治疗组和对照组各40例。两组性别、年龄、病程和入院时体温比较，差异