【大环内酯类药物单用或联用对小儿支原体肺炎的疗效分析】小儿支原体肺炎首选药物是

　　【摘要】 目的 分析比较单用红霉素、单用阿奇霉素、二者联用对小儿支原体肺炎的临床疗效。方法 将住院的90例患儿随机分为三组。A组30例，予红霉素治疗，B组31例，予阿奇霉素治疗，C组29例，予红霉素＋阿奇霉素治疗，三组药物的使用剂量、疗程相同。比较三组患儿治疗后体温、咳嗽、肺部啰音等临床症状改善时间以及肺部X线病灶消失时间。统计比较三组治疗的总有效率以及不良反应的发生情况。结果 三组患儿的退热时间、咳嗽消失时间、肺部啰音消失时间、X线病灶消失时间比较差异均有统计学意义（P＜0.01）,B组和C组的各观察指标时间显著短于于A组（P＜0.01）。B组与C组之间差异无统计学意义（P＞0.05）。三组总有效率比较差异有统计学意义（P＜0.05），C组显著高于A组（P＜0.05），B组与C组之间差异无统计学意义（P＞0.05）。A组和C组患儿均可见胃肠、给药部位静脉炎、过敏、肝损害等不良反应。三组均以胃肠反应较为多见，其发生率差异有统计学意义（P＜0.01）,B组显著低于A、C组（P＜0.01）。结论 单用阿奇霉素是一种有效且不良反应较少的治疗小儿支原体肺炎的方式。
　　【关键词】 红霉素；阿奇霉素；小儿；支原体肺炎；药物联用
　　文章编号：1003-1383(2012)04-0494-03
　　中图分类号：R 725.6 文献标识码：A
　　doi:10.3969/j.issn.1003-1383.2012.04.016
　　
　　Efficacy of macrolide drugs alone or combinated on pediatric mycoplasma pneumonia
　　GU Feng
　　(Department of Pediatrics,the People’s Hospital of Ningguo,Ningguo 242300,Anhui)
　　【Abstract】 Objective To compare the clinical efficacy of erythromycin, azithromycin and their combination on pediatric mycoplasma pneumonia.
　　Methods 90 children with mycoplasma pneumonia in our hospital were divided into 3 groups:group A (30 cases treated with erythromycin),group B (31 cases treated with azithromycin) and group C (29 cases treated with erythromycin and azithromycin). All groups used the same dose of medicine and same period of time.After appropriate treatment, the time of alleviation of clinical symptoms such as fever,cough,pulmonary rates, and chest X-ray examinations were collected for comparing. The overall response rate and adverse reactions of these three groups were recorded and compared, too.
　　Results There was significant difference in the time of defervesce, stop of cough and X-ray examining symptoms（P＜0.01）. In group B and C,the time of all observed indexes was shorter than that of group A（P＜0.01）,but there was no statistical difference in these indexes between B and C(P＞0.05). There was statistical difference in the overall response rates among the three groups(P＜0.05).Group C had much higher overall response rate than Group A(P＜0.05),but there was no significant difference between Group B and Group C(P＞0.05) .There were adverse reactions such as gastroenteropathy,the administration site phlebitis, allergy, hepatic injury in patients of Group A and Group C. Gastroenteropathy was the most commonly reverse reactions in all patients and its incidence rates had statistical difference between these groups,in which Group B had much lower rate than Group A and C(P＜0.01).
　　Conclusion Azithromycin used alone was an effective treatment for pediatric mycoplasma pneumonia with fewer adverse reactions.