吴波英等

[摘要] 目的 评价阿奇霉素序贯疗法用于小儿支原体肺炎治疗的疗效及安全性。方法 选取2012年4月～2013年6月间于我院呼吸科就诊治疗的肺炎支原体感染患儿134例，按照治疗方式差异分为观察组和对照组，分别采用阿奇霉素序贯疗法及静脉滴注红霉素进行治疗，对比分析两组患儿的临床效果及不良反应发生情况。结果 经14 d治疗后，观察组的治疗有效率为95.71%，较对照组（79.69%）显著升高（P<0.05）；观察组患儿咳嗽、发热、肺部湿啰音消失时间及住院时间均显著缩短（P<0.05）；同时，观察组的关节疼痛、皮疹、胃肠道反应、血清谷丙转氨酶升高的发生率均显著低于对照组（P<0.05）。结论 采用阿奇霉素序贯疗法治疗小儿支原体肺炎，具有良好的临床疗效，显著缩短患儿的症状消失时间及住院时间，且毒副作用小，值得在临床广泛使用。

[关键词] 小儿支原体肺炎；阿奇霉素；序贯疗法；不良反应

[中图分类号] R725.6 [文献标识码] B [文章编号] 1673-9701（2014）29-0143-03

Analysis of the efficacy and safety of Azithromycin sequential therapy in treatment with mycoplasma pneumonia

WU Boying1 ZHANG Zhe1 XU Hongzhen2

1.Department of Pediatirics，Yinzhou People's Hospital of Ningbo City，Ningbo 315040，China；2.Childrens Hospital Affiliated to Medicine College of Zhejiang University， Hangzhou 310003， China

[Abstract] Objective To evaluate the efficacy and safety of azithromycin sequential therapy in treatment with mycoplasma pneumonia. Methods A total of 134 cases with mycoplasma pneumonia were selected in respiratory department of our hospital during April 2012 to June 2013， and then divided into observation group and control group according to the different treatment， which received azithromycin sequential therapy and erythromycin intravenous infusion respectively. The clinical effects and the incidence of adverse reactions were comparatively analyzed. Results 14 d after treatment， the treatment efficiency of observation group reached 95.71%， which was significantly higher than that in control （79.69%）（P<0.05）.The fading time of coughing， the fading time of crackles and rale and the time of fever descending to normal were significantly shorter than that in control （P<0.05）. Meanwhile， the adverse reaction rate of the observation group， include joint pain， rash， gastrointestinal reactions， elevated serum alanine aminotransferase， were significantly lower than that in the control group （P<0.05）. Conclusion Azithromycin sequential therapy have a good clinical efficacy in treatment with mycoplasma pneumonia， shorten the symptoms disappearance time and hospitalization time and reduce toxicity， which is widely used in clinical practice.

[Key words] Mycoplasma pneumonia； Azithromycin； Aequential therapy； Adverse reactions

小儿肺炎支原体感染是儿科常见的呼吸道感染疾病，其发病率占呼吸道感染的30%以上，且近年来仍呈上升趋势[1]。由于支原体属于细胞内微生物，感染后往往难以清除，常引发患儿的慢性咳嗽及其他肺外合并症，严重者可诱发多脏器病变，导致患儿死亡[2]。因此，加强小儿支原体肺炎治疗的研究对于保障儿童的身体健康具有重要意义。目前，多采用红霉素对小儿支原体肺炎进行治疗，但其副作用较大，限制了其临床应用[3]。本研究选取2012年4月～2013年6月于我院呼吸科就诊治疗的肺炎支原体感染患儿134例，对比分析阿奇霉素序贯疗法及静脉滴注红霉素治疗的临床疗效及不良反应的发生情况，以期为小儿支原体肺炎的治疗提供理论依据。endprint

1 对象与方法

1.1 研究对象

选取2012年4月～2013年6月间于我院呼吸科就诊治疗的肺炎支原体感染患儿134例为研究对象。所有患者均符合以下条件：①观察患儿的临床症状及X 线胸片、病原学检查结果，参照胡亚美等编制的《诸福棠实用儿科学》（第7版）[4]中关于支原体肺炎的诊断标准进行确诊；……