不同剂量糖皮质激素与克拉霉素联合应用治疗小儿重症肺炎支原体肺炎的效果

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Abstract Objective To study the effect of different doses of glucocorticoid combined with Clarithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children. Methods A total of 156 children with severe Mycoplasma pneumoniae pneumonia treated in the First Affiliated Hospital of Hebei North University from June 2019 to August 2021 were selected as research objects. They were divided into the control group (36 cases), the observation group (40 cases), the constant group (43 cases), and the small dose group (37 cases) according to the random number table method. The control group was treated with Azithromycin, the observation group was treated with Clarithromycin, the constant group was treated with Clarithromycin combined with conventional dose glucocorticoid [1.0 mg/(kg·d)], and the small dose group was treated with Clarithromycin combined with low dose glucocorticoid [2.0 mg/(kg·d)]. Clinical indexes, peripheral blood inflammatory indexes, and adverse reactions of each group were compared. Results The days of antipyretic, cough remission, and disappearance of pulmonary murmur in the observation group were shorter than those in the control group (P < 0.05); and the days of antipyretic, cough remission and disappearance of pulmonary murmur in the constant group and small dose group were shorter than those in the observation group (P < 0.05); the days of cough remission in the small dose group were shorter than those in the constant group (P < 0.05). After treatment, the levels of hypersensitive C-reactive protein (hs-CRP), serum amyloid A (SAA), and interleukin-6 (IL-6) in control group and observation group were lower than before treatment (P < 0.05); SAA level in observation group was lower than that in control group (P < 0.05). After treatment, the levels of Hs-CRP, SAA, and IL-6 in the observation group, constant group, and small dose group were lower than those before treatment (P < 0.05); there was statistical significance in hs-CRP level among all groups (P < 0.05); SAA level in the constant group was higher than that in the observation group (P < 0.05); SAA level in the small dose group was lower than that in the constant group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between the observation group and the control group (P > 0.05); the total incidence of adverse reactions in the constant group and the small dose group were lower than that the in observation group (P > 0.05). Conclusion Clarithromycin has advantages over Azithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children. Glucocorticoid combined with Clarithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children can be applied and popularized.

Key words： Mycoplasma pneumoniae pneumonia Severe pneumonia Clarithromycin Glucocorticoid Dose difference Curative effect

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	DUAN Nana1 RONG Weiqiang2 ZHENG Maodong1 YAN Juan1 ZUO Luguang3▲

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DUAN Nana1 RONG Weiqiang2 ZHENG Maodong1 YAN Juan1 ZUO Luguang3▲. Effect of different doses of glucocorticoid combined with Clarithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia in children[J]. 中国医药导报, 2022, 19(23): 89-92,103.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I23/89

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