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目的 探讨阿奇霉素对儿童细菌性肺炎的疗效及安全性。方法 2 0 0 3年 2～ 6月在上海 4所医院用注射用门冬氨酸阿奇霉素治疗 81例儿童肺炎。门冬氨酸阿奇霉素剂量按 10mg·kg-1·d-1,加入葡萄糖液用 1～ 3h静脉慢滴 ,具体应用剂量 :≤ 1岁 6 5～ 80mg/d ,～ 4岁 12 5mg/d ,～ 7岁 2 0 0mg/d ,～ 12岁 375mg/d ,疗程 3～ 7d。观察治疗前后症状体征的变化以及外周血、肝功能、肾功能及X线胸片变化 ,并取咽部或上呼吸道分泌物做细菌培养及门冬氨酸阿奇霉素药敏试验 ,或取呼吸道分泌物及血清进行支原体等非典型病原菌抗原或抗体检测。结果 痊愈 32例 ,显效 4 3例 ,好转 6例。总有效率为 92 6 %。 11例发生不良反应 ,占 13 6 % ,其中纳差 5例 ,恶心2例 ,腹痛 2例 ,皮肤出现风团 1例 ,静脉滴入处疼痛 1例 ,除因皮肤出现风团而停药外 ,其余均继续用药 ,不良反应于 1d后消失。 3例治疗前血清丙氨酸转氨酶在 5 0U/L左右 (正常值 <4 0U/L) ,治疗后肺炎痊愈 ,2例肝功能恢复正常 ,1例无变化。结论 门冬氨酸阿奇霉素对儿童细菌感染的疗效好 ,安全性较高。
Objective To investigate the efficacy and safety of azithromycin in children with bacterial pneumonia. Methods From February to June 2003, 81 children with pneumonia were treated with azithromycin aspartate injection in 4 hospitals in Shanghai. Azithromycin aspartate dose 10mg · kg-1 · d-1, glucose solution was added intravenously 1 ~ 3h intravenous drip, the specific application dose: ≤ 1 year old 65 ~ 80mg / d, ~ 4 years old 125mg / d, ~ 7 years old 200mg / d, ~ 12 years old 375mg / d, course of treatment 3 ~ 7d. Observe the changes of symptoms and signs before and after treatment as well as peripheral blood, liver function, renal function and X-ray changes, and take the pharynx or upper respiratory secretions bacterial culture and azithromycin aspartic acid sensitivity test, or take respiratory secretions And serum for mycoplasma and other atypical pathogens antigen or antibody detection. 32 cases were cured, markedly effective in 43 cases, improved in 6 cases. The total effective rate was 92.6%. 11 cases of adverse reactions, accounting for 13.6%, of which 5 cases of anorexia, nausea in 2 cases, abdominal pain in 2 cases, the skin appears in 1 case of wind, intravenous infusion of pain in 1 case, except because the skin appears wind group and drug withdrawal , The rest were continued medication, adverse reactions disappeared after 1d. Serum alanine aminotransferase was about 50U / L (normal value <40U / L) in 3 patients before treatment, pneumonia was cured after treatment, 2 patients had normal liver function, and 1 patient had no change. Conclusion Aspartic acid azithromycin has a good effect on bacterial infection in children and is safe.