OBJECTIVE:To probe into the effects of ceftriaxone sodium combined with azithromycin on serum inflammatory factor levels and positive rate of drug-resistant gene in children with refractory Mycoplasma pneumoniae pneumonia (RMPP). METHODS:148 children with RMPP admitted into Children's Hospital Affiliated of Zhengzhou University from Feb. 2015 to Feb. 2018 were according to admission order grouping, single number as the observation group, double number as the control group, with 74 cases in each. The observation group was given ceftriaxone sodium combined with azithromycin, while the control group was treated with azithromycin alone. The clinical efficacy, serum inflammatory factor levels [interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor (TNF-α) ], positive rate of drug-resistant gene and incidences of adverse drug reactions of two groups were observed. RESULTS:The total effective rate of observation was 95.95％ (71/74), which was significantly higher than that of the control group (86.49％, 64/74), with statistically significant difference (P＜0.05); after treatment, the IL-6, IL-8 and TNF-α levels of observation group were significantly lower than those of the control group, with statistically significant differences (P＜0.05); the positive rates of drug-resistant gene of observation group and control group were respectively 6.76％ (5/74) and 8.11％ (8/74), the difference had no statistical significance (P＞0.05); the incidences of adverse drug reactions of observation group and control group were respectively 5.41％ (4/74) and 4.05％ (3/74), the difference had no statistical significance (P＞0.05). CONCLUSIONS:The efficacy of ceftriaxone sodium combined with azithromycin in treatment of RMPP is remarkable, which can reduce the inflammatory factor levels and inhibit inflammatory reaction, safe and reliable without increasing bacterial resistance and adverse reactions.%目的:探讨头孢曲松钠联合阿奇霉素对难治性肺炎支原体肺炎患儿血清炎性因子水平及耐药基因阳性率的影响.方法:选取2015年2月至2018年2月郑州大学附属儿童医院收治的难治性肺炎支原体肺炎患儿148例作为研究对象,按照入院顺序分组,单号为观察组,双号为对照组,每组74例.观察组患儿给予头孢曲松钠和阿奇霉素治疗,对照组患儿仅给予阿奇霉素治疗.观察两组患儿的临床疗效、血清炎性因子水平[白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子(TNF-α)]、耐药基因阳性情况及不良反应发生情况.结果:观察组患儿的总有效率为95.95％(71/74),明显高于对照组的86.49％(64/74),差异有统计学意义(P＜0.05);治疗后,观察组患儿血清IL-6、IL-8和TNF-α水平明显低于对照组,差异均有统计学意义(P＜0.05);观察组、对照组患儿耐药基因阳性率分别为6.76％(5/74)、8.11％(8/74),差异无统计学意义(P＞0.05);观察组、对照组患儿不良反应发生率分别为5.41％(4/74)、4.05％(3/74),差异无统计学意义(P＞0.05).结论:头孢曲松钠联合阿奇霉素治疗难治性肺炎支原体肺炎的疗效显著,可降低患儿炎性因子水平,抑制炎症反应,且不增加细菌耐药性和不良反应,安全可靠.
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