红霉素与阿奇霉素在治疗儿童支原体肺炎中的差异

霍苏琛1张丽娟2

(湖北省中山医院 1.医务部，2.院感科， 湖北 武汉 430033)

【摘要】目的探讨阿奇霉素与红霉素治疗儿童支原体肺炎的临床效果差异。方法选取2010年1月～2013年1月就诊的支原体感染性肺炎患儿90例，将其随机分为观察组及对照组各45例，观察组予阿奇霉素10mg/kg·d静脉滴注治疗，连续使用5天，然后停止用药5天，再继续应用原来剂量5天，而后再停药5天，最后改为阿奇霉素1片，每天1次口服1周；对照组予红霉素30mg/kg·d静脉滴注，每天1次，连续使用1周，而后改为红霉素1片，每天1次口服1周，其余治疗措施两组均相同，比较两组患者的症状消失时间、治疗有效率以及不良反应情况。结果观察组与对照组相比，发热、咳嗽、咽部及扁桃体充血症状消失时间以及肺部啰音体征消失时间均较对照组明显缩短(P>0.05)。观察组治疗有效率为88.64%(39/45例)，较对照组的64.44%(29/45例)显著升高；观察组发生胃肠道等不良反应的发生率为13.33%，较对照组的40%降低，且症状较轻，不影响治疗。组间相比，差异均有统计学意义(P<0.05)。结论阿奇霉素应用于小儿支原体肺炎的治疗可以收到更好的临床效果，且不良反应发生率小，较红霉素效果更好。

【关键词】支原体肺炎； 阿奇霉素； 红霉素

【中图分类号】R 563.1+9；R 725.6【文献标志码】A

收稿日期：( 2014-08-04； 编辑： 母存培)

Analysis of the difference of erythromycin and azithromycin in treatment of mycoplasma pneumonia in childrenHUO Suchen1，ZHANG Lijuan2

(1.MedicalAdministrationDivision，HubeiZhongshanHospital，Wuhan430033，China;

2.DepartmentofHospitalInfectionControl,HubeiZhongshanHospital，Wuhan430033，China)

Abstract【】ObjectiveTo investigate the clinical effect of azithromycin and erythromycin in treatment of children with Mycoplasma pneumonia. Methods90 cases of infectious pneumonia were randomly divided into observation group and control group, 45 cases in each group. The observation group was treated with azithromycin 10mg/ (Kg·d) intravenously, 5 days of continuous use, then stop the medication for 5 days, and then continue to use the original dose 5 days then, stop drug 5 days, finally to azithromycin oral 1#·qd therapy for 1 weeks, and control group was treated with erythromycin 30mg/ (Kg·d) intravenously, once a day, continuous use for 1 weeks, then changed to oral erythromycin 1#·qd 1 weeks of treatment, the treatment of the two groups were the same. The symptoms disappeared time, the effective rate and adverse reaction conditions were observed. ResultsThe fever, cough, pharynx and tonsil congestive symptoms disappear time of pulmonary rales signs disappeared time of observation group were significantly shorter than that of the control group (P<0.05). The adverse reaction rate of observation group (3.33%) was lower than that of occurred (P<0.05). ConclusionAzithromycin in treatment of mycoplasma pneumonia in children can get a better clinical effect and less adverse reactions.

【Key words】Mycoplasma pneumonia; Azithromycin; Erythromycin

肺炎支原体肺炎(MP)是一种常见的呼吸系统感染性疾病，常见于免疫功能低下的小儿以及老年人[1]。如何对MP进行合理有效地治疗是临床上热点讨论的话题。过去对于MP的治疗多选用红霉素，它主要通过抑制酰基转移酶，抑制细菌蛋白质合成而发挥作用。但是使用该药治疗在细胞内以及细胞外的药物浓度均较低，且容易发生较大的不良反应，药物的半衰期较短，甚至还会导致耐药。阿……