目的：观察阿奇霉素序贯疗法联合特步他林治疗小儿支原体肺炎的疗效和安全性。方法：将130例支原体肺炎患儿随机均分为对照组与观察组。对照组患儿采用阿奇霉素序贯疗法，即给予阿奇霉素注射液10 mg/kg，静脉滴注，每日1次，连续使用3～5 d，随后休息4 d，再给予阿奇霉素分散片10 mg/kg，顿服，每日1次，连续使用3 d，随后休息4 d；观察组患儿在对照组治疗的基础上给予特布他林注射液2.5 mg，加入0.9％氯化钠注射液5 ml中，雾化吸入，每日2次，每次10～15 min，雾化后给患儿喂食温开水。两组疗程均为2周。观察两组患儿临床疗效，治疗前后细胞因子[肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、IL-8]水平变化，相关症状、体征（喘憋、啰音、咳嗽、发热）消失时间、住院时间和不良反应发生情况。结果：治疗后，观察组患儿有效率显著高于对照组，TNF-α、IL-6、IL-8水平均显著低于对照组，相关症状、体征消失时间和住院时间均显著短于对照组，差异均有统计学意义（P＜0.05）；两组患儿不良反应发生率比较差异无统计学意义（P＜0.05）。结论：阿奇霉素序贯疗法联合特布他林雾化能有效改善患儿的细胞因子水平，提高临床疗效，且安全性较好。%OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy combined with terbutaline in the treatment of mycoplasma pneumonia. METHODS:130 children with mycoplasma pneumonia were randomly divided into control group and observation group. Control group was given azithromycin sequential therapy by using 10 mg/kg Azithromycin dispersible tablet by intravenous infusion,once a day,for continuous 3-5 d,then rested for 4 d,and then given 10 mg/kg Azithromycin dis-persible tablet at a draught,once a day,for continuous 3 d,then rested for 4 d;observation group was additionally given 2.5 mg Terbutaline injection adding into 5 ml sodium chloride injection by inhalation via oxygen atomization,twice a day,10-15 min ev-ery times,and then the children were fed with warm boiled waterafter atomization. The treatment course for both groups was 4 weeks. Clinical efficacy,and changes of cytokines levels [tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),IL-8],disap-peared time of related symptoms and signs (wheezing,rales,coughing,fever),hospitalization time before and after treatment, and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,the effective rate in observation group was significantly higher than control group,levels of TNF-α,IL-6 and IL-8 were significantly lower than control group,disap-peared time of related symptoms and signs and hospitalization time were significantly shorter than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Azithromycin sequential therapy combined with terbutalineaerosol therapycan effectively improve the cytokines levels and clinical efficacy,with good safety.
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