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目的探讨阿奇霉素和头孢他啶对难治性肺炎支原体肺炎患儿的临床疗效及血清乳酸脱氢酶(LDH)的变化影响。方法 2014年1月—2017年1月选择在郑州市妇幼保健院诊治的120例难治性肺炎支原体肺炎患儿作为研究对象,根据随机信封抽签原则分为观察组与对照组各60例,观察组在常规治疗基础上给予阿奇霉素辅助治疗,0.25 g/次,1次/d,对照组在常规治疗基础上给予头孢他啶辅助治疗,10~50 mg/kg加入0.5%氯化钠注射液50~100 m L内,静脉泵入,2次/d。两组都治疗14 d。结果观察组与对照组患儿总有效率分别为98.3%和86.7%,观察组患儿的总有效率显著高于对照组,差异有统计学意义(P<0.05)。观察组与对照组患儿治疗后的血清LDH水平分别为(143.22±26.29)U/L和(245.10±30.91)U/L,都明显低于治疗前的(445.20±35.10)U/L和(438.10±56.11)U/L(P<0.05);且治疗后观察组患儿的血清LDH水平也明显低于对照组,差异有统计学意义(P<0.05)。观察组患儿治疗期间的皮疹、胃肠道反应、疼痛、发热等不良反应发生率为11.7%,对照组为10.0%,两组对比无明显差异。结论相对于头孢他啶,阿奇霉素治疗难治性肺炎支原体肺炎患儿能提高治疗效果,且不会增加不良反应,其作用机制可能与促进血清LDH含量降低有关。
Objective To investigate the clinical effects of azithromycin and ceftazidime on the changes of serum lactate dehydrogenase (LDH) in children with refractory Mycoplasma pneumoniae pneumonia. Methods From January 2014 to January 2017, 120 children with refractory mycoplasma pneumoniae pneumonia were selected and treated in Zhengzhou Maternal and Child Health Hospital. According to random sampling, 60 cases were divided into observation group and control group. The patients in the control group were given adjuvant azithromycin (0.25 g / time, once a day) on the basis of conventional treatment. The patients in the control group were given ceftazidime adjuvant on the basis of conventional treatment. The patients in the control group were given 50% to 100% sodium chloride injection m L, intravenous infusion, 2 times / d. Both groups were treated for 14 days. Results The total effective rate in observation group and control group was 98.3% and 86.7% respectively. The total effective rate in observation group was significantly higher than that in control group (P <0.05). The levels of serum LDH in the observation group and the control group after treatment were (143.22 ± 26.29) U / L and (245.10 ± 30.91) U / L, respectively, which were significantly lower than those before treatment (445.20 ± 35.10) U / L and 438.10 ± 56.11) U / L (P <0.05). After treatment, the level of serum LDH in the observation group was also significantly lower than that in the control group (P <0.05). In the observation group, the incidence of rash, gastrointestinal reaction, pain, fever and other adverse reactions during treatment was 11.7% in the treatment group and 10.0% in the control group, with no significant difference between the two groups. Conclusion Compared with ceftazidime, azithromycin in children with refractory mycoplasma pneumoniae pneumonia can improve the therapeutic effect, and does not increase adverse reactions, the mechanism may be related to the promotion of serum LDH levels decreased.