孟鲁司特钠联合阿奇霉素治疗小儿支原体肺炎并继发性哮喘的临床研究

中国药物评价 ›› 2022, Vol. 39 ›› Issue (2): 176-179.

孟鲁司特钠联合阿奇霉素治疗小儿支原体肺炎并继发性哮喘的临床研究

宋永会

郑州市金水区总医院，河南郑州 450000

收稿日期:2021-09-02 修回日期:2022-03-22 出版日期:2022-04-28 发布日期:2022-04-28

Montelukast Combined with Azithromycin on Children with Mycoplasma Pneumonia and Secondary Asthma

Zhengzhou Jinshui District General Hospital, Henan Zhengzhou 450000, China

Received:2021-09-02 Revised:2022-03-22 Online:2022-04-28 Published:2022-04-28

摘要/Abstract

摘要：

目的：探讨孟鲁司特钠和阿奇霉素联合治疗小儿肺炎支原体继发性哮喘发作的临床效果。方法：本研究纳入200例诊断为继发性哮喘发作的支原体肺炎患儿，依据随机抽签法分为观察组与对照组，各100例。对照组接受阿奇霉素和支气管扩张药或糖皮质激素的联合治疗。观察组在对照组基础上加用孟鲁司特钠联合治疗。比较两组治疗前后的肺功能指标，T淋巴细胞亚群，细胞因子水平，免疫球蛋白G(IgG)和免疫球蛋白M(IgM)阳性率，哮喘控制率和复发率。结果：观察组肺功能各项指标升高明显高于对照组(P＜0.05)；观察组T淋巴细胞亚群(CD4^＋、CD4^＋/ CD8^＋)升高明显高于对照组(P＜0.05)；观察组T淋巴细胞亚群(CD8^＋)下降明显低于对照组(P＜0.05)；观察组白介素-10(IL-10)，白介素-17(IL-17)和转化生长因子-β(TGF-β)水平下降明显低于对照组(P＜0.05)；两组IgG和IgM阳性率与干预前相比明显下降(P＜0.05)。观察组的哮喘控制率高于对照组，哮喘复发率低于对照组(P＜0.05)。结论：孟鲁司特钠联合阿奇霉素治疗儿童小儿支原体肺炎并继发性哮喘发作，可缓解炎症反应，增强患者免疫功能，改善肺功能。

关键词: 小儿支原体肺炎, 孟鲁司特钠, 阿奇霉素

Abstract:

Objective：To investigate the clinical effect of montelukast and azithromycin in the treatment of children with secondary asthma attacks of Mycoplasma pneumoniae. Methods：In this study, 200 children with mycoplasma pneumonia diagnosed as secondary asthma attack were randomly divided into observation group and control group, with 100 cases in each group. Observation group received montelukast sodium, azithromycin and bronchodilator or glucocorticoid combined treatment. Azithromycin was treated in combination with bronchodilators or glucocorticoids. Lung function indexes, T lymphocyte subsets, cytokine levels, positive rates of immunoglobulin G (IgG) and immunoglobulin M (IgM), asthma control rate and recurrence rate were compared between the two groups before and after treatment. Results：After the intervention, the indexes of pulmonary function in the observation group were significantly higher than those in the control group (P<0.05，and the T lymphocyte subsets (CD4^＋， CD4^＋/CD8^＋) in the observation group were significantly higher than those in the control group (P<0.05). The decrease of T lymphocyte subsets (CD8^＋) in the observation group was significantly lower than that in the control group (P<0.05). Interleukin-10 (IL-10), interleukin-17 (IL-17) and transforming growth factor were observed in the observation group-β(TGF-β).The positive rates of IgG and IgM in the observation group were significantly lower than those before the intervention (P<0.05). Conclusion：Montelukast sodium combined with azithromycin in the treatment of mycoplasma pneumonia in children with secondary asthma attack can relieve inflammatory response, enhance the immune function of patients, improve lung function.

Key words: Mycoplasma pneumoniae in children, Montelukast, Azithromycin

中图分类号:

R563.13

宋永会.

孟鲁司特钠联合阿奇霉素治疗小儿支原体肺炎并继发性哮喘的临床研究 [J]. 中国药物评价, 2022, 39(2): 176-179.

SONG Yong-hui.

Montelukast Combined with Azithromycin on Children with Mycoplasma Pneumonia and Secondary Asthma [J]. CHINESE JOURNAL OF DRUG EVALUATION, 2022, 39(2): 176-179.

参考文献

[1] 刘芳君，龚财惠，秦江蛟，等. 肺炎支原体肺炎婴幼儿肺功能的变化[J]. 中国当代儿科杂志， 2020，96(28)：141-143.

[2] 王亨，赵顺英. 儿童难治性肺炎支原体肺炎的发病机制和诊治研究进展[J]. 世界临床药物， 2020，341(5)：71-80.

[3] Shimizu T. Inflammation-inducing factors of Myco-plasma pneumoniae[J]. Front Microbiol，2016, 7(2): 414-420.

[4] 朱维霞，李秀云，毕玫荣，等. 儿童喘息性支气管肺炎170例临床分析[J]. 潍坊医学院学报， 2019，41(2)：104-107.

[5] Bébéar C, Raherison C, Nacka F, et al. Comparison of Mycoplasma pneumoniae infections in asthmatic children versus asthmatic adults. [J]. Pediatr Infect Dis，2014，33(97)：71-75.

[6] Bateman ED, Goehring UM, Richard F, et al. Roflumilast combined with montelukast versus montelukast alone as add-on treatment in patients with moderate-to-severe asthma[J].Allergy Clin Immunol，2019，23(68): 45-46.

[7] 路一平，崔晓燕，张莉，等.小儿支气管肺炎支原体感染的临床检验效果[J]. 医学食疗与健康， 2020, 18(11)：193-194.

[8] 龚春华，刘芳.293例儿童肺炎支原体肺炎的临床分析[J]. 同济大学学报(医学版), 2020，41(3)：65-71.

[9] Saraya T. The history of mycoplasma pneumoniae pneumonia[J].Front Microbiol，2019, 7(91): 364.

[10] 王亨，赵顺英.儿童难治性肺炎支原体肺炎的发病机制和诊治研究进展[J]. 世界临床药物， 2020，341(5)：71-80.

[11] 张丹丹，姜艳群，范玉洁，等. 肺炎支原体肺炎患儿外周血CD3^＋CD56^＋NKT细胞变化及临床意义[J].江苏医药， 2020，56(36)：234-238.

[12] Hansbro PM, Starkey MR, Mattes J, et al. Pulmonary immunity during respiratory infections in early life and the development of severe asthma[J]. Ann Am Thorac Soc，2019，11(5): 297-302.

[13] 程秀芳，陈俊松.肺炎支原体感染对支气管哮喘病儿外周血1，9，17型辅助性T细胞及相关细胞因子水平的影响[J].安徽医药， 2019，23(6)：158-162.

[14] Dilek F, Ozkaya E, Kocyigit A, et al. Plasma total thiol pool in children with asthma: Modulation during montelukast monotherapy[J].Immunopathol Pharmacol，2019，29(64): 84-89.

[15] 赵韵清. 用孟鲁司特钠对肺炎支原体感染后出现慢性咳嗽患儿进行治疗的效果评估[J]. 当代医药论丛， 2020，18(5)：118-119.