多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎的临床观察 点击下载
| 论文标题： | 多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎的临床观察 |
| 英文标题： | |
| 中文摘要： | 目的 探讨多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎（MUMPP）的疗效与安全性。方法回顾性收集2023年1月1日至12月31日宁波大学附属妇女儿童医院收治的8岁以下MUMPP患儿资料，根据不同抗感染治疗方案分为多西环素组（44例）、多西环素联合甲泼尼龙组（35例）、阿奇霉素联合甲泼尼龙组（35例）。多西环素组患儿给予盐酸多西环素肠溶胶囊；多西环素联合甲泼尼龙组患儿给予盐酸多西环素肠溶胶囊+注射用甲泼尼龙琥珀酸钠；阿奇霉素联合甲泼尼龙组患儿给予注射用阿奇霉素+注射用甲泼尼龙琥珀酸钠；3组疗程均为10d。比较3组患儿的退热率、退热时间、肺部感染吸收好转率，记录其住院期间及出院后5个月内的不良反应发生情况。结果多西环素组、多西环素联合甲泼尼龙组患儿治疗后48、72h的退热率及肺部感染吸收好转率均显著高于阿奇霉素联合甲泼尼龙组，退热时间显著短于阿奇霉素联合甲泼尼龙组（P＜0.05），而多西环素组与多西环素联合甲泼尼龙组比较，差异无统计学意义（P＞0.05）。3组患儿住院期间及出院后5个月内的皮疹、呕吐、腹痛、腹泻及转氨酶升高的发生率比较，差异均无统计学意义（P＞0.05）；使用多西环素的患儿均未出现牙齿发黄、牙釉质发育不良。结论多西环素用于8岁以下儿童MUMPP的疗效和安全性均较好；辅助使用低剂量糖皮质激素并不一定能带来明显的额外疗效。 |
| 英文摘要： | OBJECTIVE To investigate the efficacy and safety of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia （MUMPP） in children under 8 years of age. METHODS The medical records of children with MUMPP admitted to the Women and Children’s Hospital Affiliated to Ningbo University were collected from January 1st， 2023 to December 31st， 2023. They were divided into doxycycline group （44 cases）， doxycycline combined with methylprednisolone group （35 cases）， and azithromycin combined with methylprednisolone group （35 cases） according to the treatment methods. Doxycycline group was given Doxycycline hyclate enteric-coated capsules； doxycycline combined with methylprednisolone group was given Doxycycline hyclate enteric-coated capsules and Methylprednisolone sodium succinate for injection； azithromycin combined with methylprednisolone group was given Azithromycin for injection and Methylprednisolone sodium succinate for injection. Treatment courses of 3 groups lasted for 10 d. The fever reduction rate， the time of fever reduction and improvement rate of lung infection absorption were compared among the three groups. The occurrence of adverse drug reactions was recorded during their hospitalization and followed up within 5 months after discharge. RESULTS The fever reduction rats 48， 72 h after treatment and improvement rate of lung infection absorption in doxycycline group and doxycycline combined with methylprednisolone group were significantly higher than azithromycin combined with methylprednisolone group； the time of fever reduction was significantly shorter than azithromycin combined with methylprednisolone group （P＜0.05）； there was no statistical significance in the difference between the doxycycline group and the doxycycline combined with methylprednisolone group （P＞0.05）. There was no statistical significance in the incidence of rash， vomiting， abdominal pain， diarrhea， and elevated transaminases among the three groups during hospitalization and within 5 months after discharge （P＞0.05）. None of the children treated with doxycycline suffered from tooth discoloration or enamel hypoplasia. CONCLUSIONS Doxycycline has good efficacy and safety in therapy of MUMPP in children under 8 years of age； adjunctive coadministration of low-dose glucocorticoids does not necessarily result in significant additional efficacy. |
| 期刊： | 2025年第36卷第04期 |
| 作者： | 李珊珊；郑吉善；陈燕燕；沈珑慧 |
| 英文作者： | LI Shanshan，ZHENG Jishan，CHEN Yanyan，SHEN Longhui |
| 关键字： | 多西环素；大环内酯类药物无反应性肺炎支原体肺炎；儿童；疗效；安全性 |
| KEYWORDS： | doxycycline； macrolide-unresponsive Mycopla- |
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