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目的探讨丙种球蛋白联合阿奇霉素治疗难治性肺炎支原体肺炎的疗效。方法将吉林大学第一医院小儿呼吸科就诊的难治性肺炎支原体肺炎患儿共50例随机分为治疗组和对照组各25例,两组患儿均采用规范综合治疗,治疗组在此基础上在入院第1天即加用丙种球蛋白,剂量为400 mg·kg~(-1)·d~(-1),缓慢静点,共5 d;对两组患者临床症状和体征消失时间、肺部影像学改善时间、炎症指标、肺功能改善时间及程度、不良反应等进行观察。结果治疗组临床治疗总有效率明显高于对照组,发热缓解时间及影像学改善时间均明显短于对照组,咳嗽缓解时间及肺部啰音消失时间均明显短于对照组,血沉、CRP水平较对照组明显降低,差异均有统计学意义(P<0.05);肺功能主要指标FEV1、FVC、MMEF以及VT、tL/tE、tPTEF/tE在治疗后第3天或第5天有明显改善,两组差异有统计学意义(P<0.05);两组患儿均无明显不良反应。结论丙种球蛋白可有效缩短难治性肺炎支原体肺炎的病程,提高治疗有效率、安全,并可减轻机体的炎症反应;丙种球蛋白联合阿奇霉素治疗难治性肺炎支原体肺炎具有更显著的临床效果。
Objective To investigate the efficacy of gamma globulin combined with azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia. Methods A total of 50 patients with refractory Mycoplasma pneumoniae pneumonia treated in pediatric respiratory department of the First Hospital of Jilin University were randomly divided into treatment group and control group, 25 cases in each group. Both groups were treated with standard combination therapy. The treatment group was based on this On the first day of admission, gamma globulin was added at a dose of 400 mg · kg -1 d · d -1 for 5 days. The clinical symptoms and signs disappeared in both groups , Time of pulmonary imaging improvement, index of inflammation, time and degree of improvement of pulmonary function, adverse reaction and so on were observed. Results The total effective rate of clinical treatment in the treatment group was significantly higher than that in the control group. The duration of fever relief and imaging improvement were significantly shorter than those in the control group. The duration of cough relief and the disappearance of pulmonary rales were significantly shorter than those in the control group. Erythrocyte sedimentation rate and CRP level (P <0.05); FEV1, FVC, MMEF and VT, tL / tE and tPTEF / tE, the main indexes of pulmonary function, were significantly improved on the 3rd or 5th day after treatment , The difference between the two groups was statistically significant (P <0.05); no significant adverse reactions in both groups of children. Conclusion Gamma globulin can shorten the course of refractory Mycoplasma pneumoniae pneumonia, improve the treatment efficiency and safety, and can reduce the body’s inflammatory response; gamma globulin combined with azithromycin treatment of refractory Mycoplasma pneumoniae pneumonia has more significant clinical effects.