两种剂量糖皮质激素在儿童难治性支原体肺炎中的疗效

周宏媛; 马莉娟; 杨君; 王娴娴; 吴令琴; 单子鸿; 王舒颖; 周瑞

doi:10.13898/j.cnki.issn.1000-2020.07.013

两种剂量糖皮质激素在儿童难治性支原体肺炎中的疗效

Comparison of curative effects of two different doses of glucocorticoid in children with RMPP

摘要

摘要:
目的探讨两种剂量糖皮质激素在儿童难治性支原体肺炎（RMPP）中的疗效及不良反应。
方法回顾性收集接受全身性糖皮质激素治疗的97例RMPP患儿的数据。按用药剂量不同将患儿分为：小剂量组，甲基强的松龙 < 1 mg·kg^-1·d^-1，或其当量；常规剂量组，甲基强的松龙1~2 mg·kg^-1·d^-1，或其当量。比较2组患儿用药后的临床过程、实验室指标、治疗效果及不良反应。
结果常规剂量组的退热时间、住院时间明显小于小剂量组（P < 0.01）。经治疗，常规剂量组C反应蛋白、降钙素原及乳酸脱氢酶低于小剂量组（P < 0.05）。2组患儿疗效比较差异无统计学意义（P>0.05）；小剂量组不良反应较常规剂量组低（P < 0.05）。
结论常规剂量糖皮质激素虽然可以缩短RMPP患儿的退热时间及住院时间，但二者疗效并无差异，且小剂量组不良反应发生率较低。

Abstract:
Objective To investigate the efficacy and adverse reactions of two different doses of glucocorticoid in the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP).
Methods The clinical data of 97 RMPP children treated with systemic glucocorticoid were retrospectively analyzed.The children were divided into the low-dose group (treatment with methylprednisolone ≤1 mg·kg^-1·d^-1, or its equivalent) and conventional dose group (treatment with methylprednisolone 1-2 mg·kg^-1·d^-1, or its equivalent).The clinical course, laboratory parameters, treatment effects and adverse reactions between two groups were compared.
Results The antipyretic time and hospitalization time in conventional dose group were significantly less than those in low-dose group (P < 0.01).After treatment, the levels of CRP, PCT and LDH in conventional dose group were lower than those in low-dose group (P < 0.05).There was no statistical significance in the curative effects between two groups (P>0.05).The incidence rate of adverse reactions in low-dose group were lower than those in conventional dose group (P < 0.05).
Conclusion Although the conventional dose of glucocorticoid can shorten the antipyretic time and hospitalization of children with RMPP, there is no difference in the efficacy between two doses, and the incidence rate of adverse reactions in the low-dose group is lower.

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