选择性药物治疗儿童支原体肺炎对照探究.docVIP

选择性药物治疗儿童支原体肺炎对照探究 　【关键词】 ,阿奇霉素 【摘要】 目的 选用阿奇霉素与红霉素治疗儿童支原体肺炎并进行疗效和不良反应的对照观察。方法 选择支原体肺炎患儿80例。随机分为两组，40例采用阿奇霉素10mg/（kg#12539;d）静脉滴入，连用3天，停3～4天，再用3天；40例采用红霉素30mg/（kg#12539;d），分2次，q12h静脉滴入，连用14天。用专用表格记录患儿治疗前的病情和在疗程中逐日观察记录症状、体征的变化及不良反应，并于治疗前后做有关的实验室检查和摄X线胸片，按疗效判断标准比较两组的疗效和不良反应。结果 阿奇霉素组的痊愈率（90%）明显高于红霉素组（56.8%）（χ2=3.85，P＜0.05）；症状、体征消失较快（P均＜0.05）；而不良反应明显较少，为15%∶52.5%（χ2=12.58，P＜0.01）。结论 阿奇霉素治疗儿童支原体肺炎疗效好，疗程短，用法简便，不良反应少，值得推广。 　　【关键词】 阿奇霉素；红霉素；支原体肺炎 　　Comparative study of different drug for the treatment of myeoplasmal pneumonia in children 　　【Abstract】 Objective To compare the efficacy and adverse reactions of azithromycin and erythromycin for the treatment of mycoplasmal pneumonia in children.Methods A group of 80 children with mycoplasmal pneumonia were selected and divided by draw lots into two groups of interval.40 cases were treated with azithromycin at a dose of 10mg/kg once daily for 3 days,followed by the same treatment after 3 days of interval.40 cases were treated with erythromycin at a dose of 15mg/kg twice daily for 14 days.The symptoms and signs before treatment and their changes as well as adverse reactions during treatment were recorded.The laboratory tests and chest X-ray were done before and after treatment.The efficacy and adverse reactions were evaluated at the end of treatment.Results The cured rate for azithromycin group was significantly higher than that of erythromycin group (P＜0.05) and the incidence of adverse reactions was significantly lower (P＜0.01).Conclusion Azithromycin treating child with mycoplasmal pneumonia has good efficacy and less adverse reactions,thus can be spreaded to use. 　　【Key words】 azithromycin;erythromycin;mycoplasmal pneumonia 近年来儿童支原体肺炎的发病率有上升趋势，传统治疗采用红霉素静脉滴注或口服，因疗程长，给药次数频，不良反应多，患儿常因胃肠道反应或肝功能损害而中断治疗，导致治疗不彻底或复发。本文采用新一代大环内酯类的阿奇霉素与红霉素做一前瞻性对照研究，比较其治疗儿童支原体肺炎的疗效和不良反应，旨在为本病的治疗提供一种新的更好的药物治疗方法。 　　1 资料与方法 　　1.1 病例选择标准 　　（1）为我院初诊入院患儿，入院前1周内未用过大环内酯类药物；（2）症状、体征、胸部X线片、病原学检查符合《诸福棠实用儿科学》支原体肺炎诊断标准［1］；（3）无其他严重并发症；（4）无肝脏疾病或肝功能异常；（5）无大环内酯类过敏史