阿奇霉素联合转移因子口服溶液治疗小儿肺炎支原体肺炎临床疗效观察

1、阿奇霉素联合转移因子口服溶液治疗小儿肺炎支原体肺炎临床疗效观察         09-08-25 11:19:00     作者：黄名寿，张一宁，赵珊    编辑：studa20【摘要】  目的：探讨阿奇霉素联合转移因子口服溶液对小儿肺炎支原体肺炎的疗效。方法：肺炎支原体肺炎患儿100例随机分为观察组和对照组各50例，观察组采用阿奇霉素联合转移因子口服溶液治疗，对照组单用阿奇霉素。疗程2周结束后观察疗效，随访2月观察有无复发。

2、结果：观察组发热、咳嗽、肺部体征消失和X线胸片恢复时间和对照组比较差异均有统计学意义（P<0.05）；两组间治愈率差异有统计学意义（P<0.05）；观察组无复发，对照组3例（6）复发。结论：阿奇霉素联合转移因子口服溶液治疗小儿肺炎支原体肺炎疗程短，治愈率高，复发率低，提示联合用药具有明显的优越性。 【关键词】  肺炎支原体肺炎；免疫调节剂；联合用药    Abstract Objective:To investigate the therapeutic efficacy of azithromycin with transfer factor

3、 oral solution in treatment of children with mycoplasma pneumoniae pneumonia (MPP). Methods: 100 cases of children with MPP were randomly divided into two groups with 50 cases each: the observation group received the combined therapy of azithromycin with transfer factor oral solution, while the cont

4、rol group received the therapy of azithromycin only, and then comparison was made between the two groups in clinical effects in the end of the course of 2 weeks treatment and followup visits were made after 2month to see whether there was any recrudescence. Results: There was a significant differenc

5、e between the two groups (P<0.05) in the time of the disappearance of fever, cough and pulmonary signs and of Xray recovery, and there was also a statistic difference in curative rate (P<0.05). No case relapsed in the observation group while 3 cases (6%) in the control group. Conclusions: The

6、combined therapy of azithromycin with transfer factor oral solution has obvious superiority with shorter courses, higher curative rate and lower relapse rate than single azithromycin in treatment of children with MPP.    Key words   Mycoplasma pneumoniae pneumonia; Immunoreg

7、ulant; Drug combination    近年来，随着肺炎病原学的变迁，肺炎支原体（Mycoplasma pneumoniae，MP）感染率明显增加，肺炎支原体已成为儿童肺炎的重要病原，且有流行趋势1。小儿肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia，MPP）常年均可发生，治疗不当易致病情加重，迁延不愈。我科2002年5月2007年5月采用阿奇霉素联合转移因子口服溶液治疗小儿肺炎支原体肺炎50例并与单用阿奇霉素治疗50例进行对照研究，现报道如下。    1  资料与方法 

8、;   1.1  一般资料    100例均为本院初诊的住院患儿，符合诸福棠实用儿科学关于肺炎支原体肺炎的诊断标准2，无其他严重并发症肝脏疾病和肝功异常及大环内酯类药物过敏史，入院前1周未用大环内酯类或喹诺酮类药物。将入选病例按入院顺序随机分为观察组和对照组各50例。两组患儿均有咳嗽，初期多表现为刺激性干咳，后期咳嗽有少许白色粘痰；发热观察组27例，对照组25例；肺部可闻干湿啰音：观察组40例，对照组38例；X线肺部检查：观察组肺门阴影增多增粗为主（A）28例，斑片影（B）18例，大片高密度影（B）4例，对照组肺门阴影增多增粗为主（A

9、）33例，斑片影（B）17例。两组冷凝集试验均阳性，支原体IgM阳性。两组病例在性别年龄临床表现及X线胸片改变等方面差异无统计学意义（P>0.05），见表1。    1.2  治疗方法    对照组采用门冬氨酸阿奇霉素针（博抗，海南斯达制药有限公司）10 mg/(kg·d)静脉滴注，最大量小于0.5 g/d，1次/d，每周用3 d停4 d，连用2周，同时给予退热止咳化痰等对症处理。观察组在对照组基础上加用转移因子口服溶液（长春精优药业股份有限公司）10 mL/次，1次/d，2周为一疗程。疗程结束后判定疗效。表

10、1  两组MPP患儿一般临床资料比较    1.3  疗效评定3    痊愈：用药后3 d内体温恢复正常，5 d内咳嗽停止，10 d内肺部干湿啰音及X线胸片检查肺部阴影完全消失。显效：用药后3 d内体温正常，7 d内咳嗽缓解，10 d内肺部干湿啰音明显减少，X线胸片检查肺部阴影基本消失。好转：用药7 d体温基本恢复正常，一疗程结束时咳嗽症状仍存在但较治疗前明显减轻，肺部体征及X线胸片检查肺部阴影有所减轻。无效：用药疗程结束时仍有发热或刺激性咳嗽，肺部体征及X线胸片检查肺部阴影仍存在。痊愈显效和好转判为有效。    1.4  统计学处理    两组一般资料中计量资料和治疗后主要临床指标比较采用t检验，一般资料中计数资料和疗效比较采用2检验。    2  结果&