目的 探讨在大叶性肺炎患儿中应用阿奇霉素联合头孢哌酮舒巴坦的疗效和作用。方法 选取中信惠州医院2020年1月—2023年6月收治的60例大叶性肺炎患儿为研究对象，以随机数字表法分为对照组与观察组，各30例。对照组给予头孢哌酮舒巴坦治疗，观察组增加应用阿奇霉素治疗。对比2组临床疗效、临床症状改善时间、血清炎症因子、呼吸力学参数及免疫功能。结果 观察组临床总有效率为93。33％，高于对照组的70。00％(P<0。05)。观察组退热时间、咳嗽消失时间、啰音消失时间以及X线胸片恢复正常时间均短于对照组(P<0。05)。治疗前，2组白介素-2(interleukin-2，IL-2)、白介素-17(interleukin-17，IL-17)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)比较，差异无统计学意义(P>0。05);治疗后，2组IL-2、IL-17、TNF-α低于治疗前(P<0。05);观察组IL-2、IL-17、TNF-α低于对照组(P<0。05)。治疗前，2组肺顺应性、胸廓顺应性、总动态顺应性比较，差异无统计学意义(P>0。05);治疗后，2组肺顺应性、胸廓顺应性、总动态顺应性高于治疗前(P<0。05);观察组肺顺应性、胸廓顺应性、总动态顺应性高于对照组(P<0。05)。治疗前，2组辅助T细胞(helper T lymphocyte，CD4+)、细胞毒性T细胞(cytotoxic T lymphocyte，CD8+)及辅助T细胞/细胞毒性T细胞的比率(helper T lymphocyte/cytotoxic T lymphocyte，CD4+/CD8+)比较，差异无统计学意义(P>0。05);治疗后，2组CD8+低于治疗前，CD4+、CD4+/CD8+高于治疗前(P<0。05);观察组CD8+低于对照组，CD4+、CD4+/CD8+高于对照组(P<0。05)。结论 大叶性肺炎患儿在临床治疗时采取阿奇霉素联合头孢哌酮舒巴坦治疗可极大地提高临床疗效，并降低炎症因子水平，促使呼吸功能恢复，提升免疫力。
Efficacy of Azithromycin Combined With Cefoperazone and Sulbactam in the Treatment of Children With Lobar Pneumonia
Objective To investigate the efficacy and effect of azithromycin combined with cefoperazone and sulbactam in children with lobar pneumonia. Methods A total of 60 children with lobar pneumonia admitted to CITIC Huizhou Hospital from January 2020 to June 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with 30 cases in each group. The control group was treated with cefoperazone and sulbactam,and the observation group was treated with azithromycin on the basis of cefoperazone and sulbactam. The clinical efficacy,improvement time of clinical symptoms,serum inflammatory factors,respiratory parameters and immune function were compared between the two groups. Results The total clinical effective rate of observation group was 93.33％,which was higher than 70.00％ of control group (P<0.05). The time of fever regression,cough disappearance,rales disappearance and chest X-ray return to normal in the observation group were shorter than those in the control group (P<0.05). Before treatment,there was no significant difference in interleukin-2 (IL-2),interleukin-17 (IL-17),and tumor necrosis factor-α (TNF-α) between the two groups (P>0.05). After treatment,IL-2,IL-17 and TNF-α in 2 groups were lower than before treatment (P<0.05). The IL-2,IL-17 and TNF-α in observation group were lower than those in control group (P<0.05). Before treatment,there was no significant difference in lung compliance,thoracic compliance and total dynamic compliance between 2 groups (P>0.05). After treatment,lung compliance,thoracic compliance and total dynamic compliance in 2 groups were higher than before treatment (P<0.05). The lung compliance,thoracic compliance and total dynamic compliance in observation group were higher than those in control group (P<0.05). Before treatment,there was no significant difference in helper T lymphocyte (CD4+),cytotoxic T lymphocyte (CD8+) and helper T lymphocyte/cytotoxic T lymphocyte (CD4+/CD8+) between 2 groups (P>0.05). After treatment,CD8+in 2 groups was lower than before treatment,CD4+and CD4+/CD8+were higher than before treatment (P<0.05). CD8+in observation group was lower than control group,and CD4+and CD4+/CD8+were higher than control group (P<0.05). Conclusion Azithromycin combined with cefoperazone and sulbactam in the clinical treatment of children with lobar pneumonia can greatly improve the clinical efficacy,reduce the level of inflammatory factors,promote the recovery of respiratory function and enhance immunity.
azithromycincefoperazone and sulbactamchildren with lobar pneumoniachild patientcurative effectinterleukin-2interleukin-17tumor necrosis factor-α
万方数据
维普
