论文部分内容阅读
目的:探讨小剂量与常规剂量糖皮质激素辅助治疗小儿难治性肺炎支原体肺炎(RMPP)合并肺外并发症临床效果及安全性差异。方法:研究对象选取某院2014年7月—2016年7月收治RMPP合并肺外并发症患儿共140例,以随机数字表法分为A组(70例)和B组(70例),在联合抗生素应用基础上分别加用常规剂量(2 mg·kg-1·d-1)和小剂量(1 mg·kg-1·d-1)甲泼尼龙辅助治疗;比较两组患儿治疗显效率,治疗总有效率,临床症状改善时间,住院时间,治疗前后C反应蛋白(CRP)、乳酸脱氢酶(LDH)、D-二聚体、红细胞沉降率(ESR)水平及药物毒副作用发生率等。结果:A组患儿治疗显效率显著高于B组(P<0.05);两组患者治疗总有效率比较差异无统计学意义(P>0.05);两组患儿临床症状改善时间和住院时间比较差异无统计学意义(P>0.05);两组患者治疗后CRP、D-二聚体、LDH及ESR水平显著低于治疗前(P<0.05);但两组患儿治疗后各指标水平组间比较差异无统计学意义(P>0.05);B组患儿药物毒副作用发生率显著低于A组(P>0.05)。结论:小剂量与常规剂量糖皮质激素辅助治疗小儿RMPP合并肺外并发症临床疗效接近,但小剂量应用可有效降低药物毒副作用发生风险,提高治疗安全性。
Objective: To investigate the clinical effects and safety differences between low-dose and conventional-dose glucocorticoids in adjuvant treatment of refractory mycoplasma pneumoniae pneumonia (RMPP) complicated with extrapulmonary complication in children. Methods: A total of 140 children with RMPP combined with extrapulmonary complications were selected from a hospital from July 2014 to July 2016. The patients were divided into group A (70 cases) and group B (70 cases) by random number table. On the basis of the combination antibiotics, the two groups were given the adjuvant plus methylprednisolone (2 mg · kg-1 · d-1) and the small dose (1 mg · kg-1 · d-1) Effective rate, effective rate of treatment, time of clinical symptom improvement, length of hospital stay, levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, erythrocyte sedimentation rate (ESR) The incidence and so on. Results: The effective rate of treatment in group A was significantly higher than that in group B (P <0.05). There was no significant difference in the total effective rate between the two groups (P> 0.05). The clinical symptom improvement time and hospital stay (P> 0.05). The levels of CRP, D-dimer, LDH and ESR in the two groups were significantly lower than those before treatment (P <0.05), but the levels of CRP, There was no significant difference between the two groups (P> 0.05). The incidence of drug side effects in children in group B was significantly lower than that in group A (P> 0.05). Conclusion: The clinical efficacy of low dose and conventional dose glucocorticoid adjuvant therapy in children with RMPP combined with extrapulmonary complication is similar, but low dose can reduce the risk of drug side effects and improve the safety of treatment.