不同剂量甲基强的松龙治疗儿童难治性肺炎支原体肺炎临床疗效及安全性分析

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1、不同剂量甲基强的松龙治疗儿童难治性肺炎支原体肺炎临床疗效及安全性分析吴幼萍劳均华广东省江门幵平市妇幼保健计划生育服务中心儿科摘要：R的比较不同剂量甲棊强的松龙治疗儿童难治性肺炎支原体肺炎(RMPP)的临床疗效及安全性。方法60例儿童难治性肺炎支原体肺炎患儿，按随机数字表法分为大剂量组和小剂量组，各30例。小剂量组患儿给予I2mg/(kg，〔1)甲基强的松龙治疗，连续静脉滴注5d,再改为口服甲泼尼松龙，1周停药;大剂量组患儿给予1020mg/(kg-d)甲基强的松龙冲击治疗，连续静脉滴注3d,再改为门服甲泼尼松龙，1周停药。比较两组患儿主要症状体征消失时间

2、，治疗前及治疗后1周血清C反应蛋白(CRP)及D-二聚体(D-D)水平，治疗后3周临床治疗效果以及治疗过程中不良反应发生情况。结果两组患儿体温、咳嗽、肺部啰音消失时间及总有效率比较差异无统计学意义(P>0.05):大剂量组治疗过程中不良反应发生率为56.67%，明显高于小剂量组的23.33%，差异具有统计学意义(P〈0.05)。两组患儿治疗后CRP和D-D水平均较治疗前明显下降，差异具有统计学意义(P〈0.05);两组患儿治疗前后CRP和D-D水平比较差异均无统计学意义(P>0.05)o结论小剂量甲基强的松龙［I2mg/(kg-d),连用5d］治疗儿童难

3、治性肺炎支原体肺炎的临床疗效与大剂量相当，均能快速改善症状体征及促进生化指标恢复，但小剂量安全性显著提高。关键词：难治性肺炎支原体肺炎;甲基强的松龙;剂量;疗效;安全性;儿竜;收稿日期：2017-10-11ClinicalefficacyandsafetyanalysisofdifferentdosesofmethylprednisoloneinthetreatmentofrefractoryMycoplasmapneumoniaepneumoniainchildrenWUYou-pingLINan_deLAOJun-huaDepartmentofPed

4、iatrics，JiangmenKaipingCityMaternalandChildHealthCareFamilyPlanningServiceCenter;Abstract：ObjectiveTocomparetheclinicalefficacyandsafetyanalysisofdifferentdosesofmethylprednisoloneinthetreatmentofrefractoryMycoplasmapneumoniaepneumonia(RMPP)inchildren.MethodsAtotalof60childrenwit

5、hrefractoryMycoplasmapneumoniaepneumoniaweredividedbyrandomnumbertablemethodintohigh-dosegroupandlow-dosegroup,with30casesineachgroup.Low-dosegroupreceivedmethylprednisolonebyl2mg/(kg•d)for5dofcontinuousintravenousinfusionthenchangedtooralprednisoloneandwithdrawalin1week.High-dos

6、egroupreceivedmethylprednisolonepulsetherapyby1020mg/(kg•d)for3dofcontinuousintravenousinfusionthenchangedtooralprednisoloneandwithdrawalin1week.Comparisonweremadeondisappearancetimeofmainsymptomsandsigns,serumCreactiveprotein(CRP)andD-dimer(D_D)levelsbeforetreatmentand1weekafter

7、treatment,clinicaltreatmenteffectafter3weeksoftreatmentandoccurrenceofadversereactionsduringtreatmentbetweentwogroups.ResultsBothgroupshadnostatisticallysignificantdifferenceinbodytemperature,cough,pulmonaryraledisappearancetimeandtotaleffectiverate(P>0.05).High-dosegrouphadobvio

8、uslyhigherincidenceofadversereactionsdur