Department of Pediatrics, South China Hospital, Medical School, Shenzhen University, Guangdong, China.
Pulmonary and Critical Care Medicine, Kunming Children`s Hospital, Kunming, China.
Ital J Pediatr. 2023 Jul 8;49(1):80. doi: 10.1186/s13052-023-01491-y.
To examine the clinical impact of bronchoscope alveolar lavage (BAL) combination with budesonide, ambroxol + budesonide, or acetylcysteine + budesonide in the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP).
Eighty-two RMPP patients admitted to Pediatrics at The First People's Hospital of Zhengzhou were retrospectively evaluated between August 2016 and August 2019. All patients were administered BAL in addition to intravenous Azithromycin, expectoration, and nebulizer inhalation. The medications added to the BLA separated the patients into the Budesonide group, Ambroxol + budesonide group, and acetylcysteine + budesonide group. Analyzed were the variations in laboratory examination indices, improvement in lung imaging, overall effective rate, and adverse responses in the three groups.
The laboratory test indices of patients in all three groups improved significantly relative to pre-treatment levels, and the results were statistically significant. After therapy, there were no significant differences between the three groups in terms of white blood cell (WBC), C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR). Serum lactate dehydrogenase (LDH) and serum ferritin (SF) varied significantly across the three groups (P < 0.05). In the acetylcysteine + budesonide group, the absorption rate of lung imaging lesions and clinical efficacy were superior to those of the other two groups. There were no significant differences between the three groups in the occurrence of adverse events (P > 0.05).
BLA-coupled acetylcysteine + budesonide was superior to the other two groups in enhancing the effectiveness of RMPP in children, which might increase lung opacity absorption and minimize lung inflammation.
为了研究支气管肺泡灌洗（BAL）联合布地奈德、氨溴索+布地奈德、乙酰半胱氨酸+布地奈德治疗难治性肺炎支原体肺炎（RMPP）的临床效果。
回顾性分析 2016 年 8 月至 2019 年 8 月在郑州市第一人民医院儿科收治的 82 例 RMPP 患者，所有患者均在静脉滴注阿奇霉素、咳痰、雾化吸入的基础上给予 BAL 治疗，根据 BAL 中添加的药物将患者分为布地奈德组、氨溴索+布地奈德组、乙酰半胱氨酸+布地奈德组，分析三组患者实验室检查指标变化、肺部影像学改善情况、总有效率及不良反应。
三组患者实验室检查指标均较治疗前明显改善，差异有统计学意义（P<0.05），治疗后三组患者白细胞（WBC）、C 反应蛋白（CRP）、红细胞沉降率（ESR）比较，差异均无统计学意义（P>0.05），但三组患者血清乳酸脱氢酶（LDH）、血清铁蛋白（SF）比较，差异有统计学意义（P<0.05）。乙酰半胱氨酸+布地奈德组肺部影像学病灶吸收、临床疗效均优于其他两组。三组不良反应发生率比较，差异无统计学意义（P>0.05）。
BAL 联合乙酰半胱氨酸+布地奈德治疗儿童 RMPP 疗效优于其他两组，可提高疗效，促进肺部阴影吸收，减轻肺部炎症。
