多西环素治疗儿童大环内酯类耐药支原体肺炎疗效评价.docVIP

多西环素治疗儿童大环内酯类耐药支原体肺炎疗效评价 　　[摘要] 目的 探讨多西环素对大环内酯类耐药支原体肺炎的临床疗效。 方法 选取2015年4～9月在湖州师范学院附属第一医院就诊的72例8周岁以上的对大环内酯类耐药的肺炎支原体肺炎患儿，其中单用阿奇霉素口服21例，单用多西环素口服23例，阿奇霉素口服联合甲强龙注射28例，分析三组患儿的年龄、性别构成比、并发症、72 h内的体温变化及药物不良反应的差异。 结果 三组患儿在年龄、性别和并发症方面无显著差异。72 h内的体温改善情况，多西环素组优于阿奇霉素组（P0.05）。同时三组患儿均无明显不良反应。 结论 对于8周岁以上大环内酯类耐药的肺炎支原体肺炎患儿，多西环素在患儿的体温改善方面体现出良好的疗效，且不良反应少。 　　[关键词] 多西环素；耐药；肺炎支原体；大环内酯 　　[中图分类号] R725.6 [文献标识码] B [文章编号] 1673-9701（2016）21-0121-04 　　[Abstract] Objective To explore the clinical curative effects of doxycycline in the treatment of macrolides-resistant mycoplasma pneumonia. Methods A total of 72 pediatric patients with macrolides-resistant mycoplasma pneumonia who were over 8 years old and were admitted to the First Affiliated Hospital of Huzhou Teachers College from April to September 2015 were selected. Among them， 21 patients were orally given azithromycin alone， 23 patients were given doxycycline alone， and 28 patients were orally given azithromycin combined with the injection of methylprednisolone. The differences of composition ratio of age and gender， complications， 72-hour temperature change and drug adverse reactions were analyzed in the three groups of pediatric patients. Results There were no significant differences in the age， gender and complications in the three groups of patients. For the improvement of 72-hour body temperature， the doxycycline group was better than that in the azithromycin group（P0.05）. There was no adverse reaction in all the three groups of patients. Conclusion For the children patients over 8 years old with macrolides-resistant mycoplasma pneumonia， the curative effect of doxycycline is better in the improvement of body temperature， and the adverse reactions are few. 　　[Key words] Doxycycline； Resistance； Mycoplasma pneumonia； Macrolides 　　肺炎支原体（mycoplasma pneumoniae，MP）是小儿呼吸道感染，特别是社区获得性肺炎的重要病原体，在儿童CAP患儿中达23%～30%，在5岁以上患儿中甚至可能占到50%[1，2]。自从2000年日本首次报道耐大环内酯类肺炎支原体肺炎（macrolide resistant mycoplasma pneumonia，MRMP）以来，世界各国相继报道MP 耐药株的出现，且MP耐药率呈逐年上