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甲泼尼龙联合阿奇霉素治疗难治性支原体肺炎的疗效及其对T淋巴细胞亚群变化的影响

Efficacy of Methylprednisolone plus Azithromycin in the Treatment of RMPP and Its Effect on the Changes of T Lymphocyte Subsets.

作者信息

Lv Jun, Fan Fei

机构信息

Department of Pediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

出版信息

Evid Based Complement Alternat Med. 2022 Apr 26;2022:1833195. doi: 10.1155/2022/1833195. eCollection 2022.

Abstract

OBJECTIVE

To explore and analyze the efficacy of methylprednisolone combined with azithromycin in the treatment of refractory pneumonia (RMPP) and its effect on the changes of T lymphocyte subsets.

METHODS

A total of 120 children with RMPP admitted to our hospital from September 2016 to September 2020 were randomized at a ratio of 1 : 1 into the control group (conventional treatment) and the observation group (methylprednisolone plus conventional treatment). Outcome measures included clinical efficacy, symptoms mitigation, changes in inflammatory factors, T lymphocyte subsets, and adverse reactions.

RESULTS

Compared with the control group, the total clinical effective rate of the observation group was higher ( < 0.05). The disappearance time of cough, wheezing, pulmonary rales, and X-ray lung shadows in the observation group was significantly shorter than that in the control group after treatment ( < 0.05). The serum C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-), and interleukin (IL)-8 levels of the observation group after treatment were significantly lower than those of the control group ( < 0.05). Compared with the control group, the observation group had a higher CD4+ value, lower CD8+ value, and higher CD4+/CD8+ value after treatment (all < 0.05). There was no significant difference in adverse reactions between the two groups during treatment ( > 0.05).

CONCLUSION

Methylprednisolone plus azithromycin might serve as an alternative in the treatment of RMPP. It facilitates the mitigation of clinical symptoms and signs and regulates the level of inflammatory factors and cellular immune dysfunction, with good effectiveness and a high safety profile.

摘要

目的

探讨并分析甲泼尼龙联合阿奇霉素治疗难治性支原体肺炎(RMPP)的疗效及其对T淋巴细胞亚群变化的影响。

方法

选取2016年9月至2020年9月我院收治的120例RMPP患儿,按1∶1比例随机分为对照组(常规治疗)和观察组(甲泼尼龙加常规治疗)。观察指标包括临床疗效、症状缓解情况、炎症因子变化、T淋巴细胞亚群及不良反应。

结果

与对照组相比,观察组总临床有效率更高(P<0.05)。治疗后,观察组咳嗽、喘息、肺部啰音及X线肺部阴影消失时间均明显短于对照组(P<0.05)。观察组治疗后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素(IL)-8水平均明显低于对照组(P<0.05)。与对照组相比,观察组治疗后CD4+值更高,CD8+值更低,CD4+/CD8+值更高(均P<0.05)。两组治疗期间不良反应差异无统计学意义(P>0.05)。

结论

甲泼尼龙加阿奇霉素可作为RMPP治疗的一种选择。它有助于缓解临床症状和体征,调节炎症因子水平及细胞免疫功能紊乱,疗效良好且安全性高。

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