李素

[摘要] 目的 分析甲潑尼龙在治疗小儿难治性肺炎支原体肺炎（RMPP）中的疗效及可行性。 方法 选取2018年11月至2021年1月于我院就诊的RMPP患儿共计68例，将患者随机分为A、B两组。A组35例予以甲泼尼龙治疗，B组33例予以常规治疗。比较两组的总有效率、临床指标、实验室指标、肺功能指标和不良反应率。 结果 A组的总有效率为97.14%，高于B组的75.76%（P<0.05）。A组的退热、咳嗽、细湿啰音、哮鸣音消退时间和住院时间均短于B组（P<0.05）。治疗前，两组患儿的实验室指标和肺功能指标比较，差异无统计学意义（P>0.05）。疗程结束后，A组患儿的各项实验室指标水平均低于B组，A组的肺功能指标优于B组（P<0.05）。A组的不良反应率为8.57%与B组的15.15%比较，差异无统计学意义（P>0.05）。 结论 为RMPP患儿采取甲泼尼龙治疗能够显著增强疗效，促进临床症状尽快消退，且能缩短治疗周期，加快炎症病灶吸收，且不会增加用药不良反应，可以保证患儿的治疗安全性，可行性较高。

[关键词] 甲泼尼龙;小儿难治性肺炎支原体肺炎;疗效;可行性

[中图分类号] R725.6          [文献标识码] B          [文章编号] 1673-9701（2021）32-0090-04

[Abstract] Objective To analyze the therapeutic efficacy and feasibility of methylprednisolone in the treatment of children with refractory mycoplasma pneumoniae pneumonia （RMPP）. Methods A total of 68 children with RMPP who were treated in our hospital from November 2018 to January 2021 were divided into group A and group B. The patients were randomly divided into two groups A and B.35 cases in group A were treated with methylprednisolone; 33 cases in group B were treated with conventional treatment.The total effective rate， clinical indicators， laboratory indicators， lung function indicators and adverse reaction rates of the two groups were compared. Results The total effective rate of group A was 97.14% higher than that of group B 75.76%（P<0.05）. The antipyretic， cough， fine damp rales， wheezing time and hospital stay in group A were shorter than those in group B（P<0.05）. Before treatment， there was no statistically significant difference in the laboratory indexes and lung function indexes of the two groups of children（P>0.05）. After the course of treatment， the laboratory index levels of the children in group A were lower than those of group B， and the lung function indexes of group A were better than those of group B（P<0.05）. The adverse reaction rate of group A was 8.57% compared with 15.15% of group B， and the difference was not statistically significant（P>0.05）. Conclusion Methylprednisolone treatment for children with RMPP can significantly enhance the therapeutic efficacy， promote the rapid resolution of clinical symptoms， shorten the treatment period， accelerate the absorption of inflammatory lesions， and do not increase adverse drug reactions， thus ensuring the safety and high feasibility of treatment for children with RMPP.

[Key words] Methylprednisolone; Refractory mycoplasma pneumoniae pneumonia （RMPP） in children; Therapeutic efficacy; Feasibility

小儿难治性肺炎支原体肺炎（Refractory mycoplasma pneumoniae pneumonia， RMPP）是临床儿科极为高发的病型，被认为是小儿群体的一大健康杀手[1]。临床认为，支原体肺炎（Mycoplasma pneumonia，MPP）无需特殊治疗，其有自限性，能够基本自愈。但在RMPP患儿数量不断增加的影响下，临床医学高度重视该病的对症治疗，以改善预后。阿奇霉素是其首选药物，可以改善炎症指标，尽快发挥治疗效用。为增强临床疗效，加快患兒病情转归，相关学者建议可在阿奇霉素等常规治疗基础上加用糖皮质激素，以实现抗炎与调节免疫等功效。……