Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia

He Yang; Gao Rongrong; Song Shiqing; Lyu Xiaoqian; Ma Zhongzheng; Yin Zhanru

doi:10.13407/j.cnki.jpp.1672-108X.2023.04.011

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Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia

更新时间：2023-04-28

- Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia
- Vol. 29, Issue 4, Pages: 40-43(2023)
- 作者机构：
  
  1. 河北衡水市人民医院,河北,衡水,053000
  2. 河北深州市人民医院,河北深州,053800
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2023.04.011
  CLC：
- Published：2023，
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He Yang, Gao Rongrong, Song Shiqing, et al. Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia. [J]. 29(4):40-43(2023)
DOI：

He Yang, Gao Rongrong, Song Shiqing, et al. Comparison of Efficacy and Safety of Dexamethasone Versus Methylprednisolone in the Treatment ofChildren with Refractory Mycoplasma Pneumoniae Pneumonia. [J]. 29(4):40-43(2023) DOI： 10.13407/j.cnki.jpp.1672-108X.2023.04.011.

摘要

目的:探讨地塞米松与甲泼尼龙治疗儿童难治性肺炎支原体肺炎( RMPP) 的临床疗效及安全性差异。方法:128 例 RMPP 患儿按随机数表法分为A 组(63 例) 和B 组(65 例)。在常规治疗基础上

A 组给予地塞米松0. 35 mg/ ( kg·d)

每日 1 次静脉滴注

B 组给予甲泼尼龙2 mg/ (kg·d)

每日2 次静脉滴注

疗程均为5 d

比较两组患儿治疗总有效率、临床症状改善情况、血浆心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)]及药物不良反应发生情况。结果:B 组总有效率为86. 15%

高于A 组的71. 43%(P< 0. 05)。B 组患儿体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间和X 线胸片肺部阴影消失时间分别为(4. 55±1. 05) d、 (6. 67±1. 12)d、(10. 76±1. 47)d 和(7. 97±1. 03)d

短于A 组的(5. 24±1. 42)d、(7. 23±1. 57)d、(11. 63±2. 52)d 和(8. 43±1. 26)d

差异均有统计学意义(P 均<0. 05)。治疗后

两组患儿CK、CK-MB、LDH、TNF-α、IL-6 和IFN-γ 水平均低于治疗前( P<0. 05)

且 B 组降低幅度更大(P<0. 05)。A 组不良反应发生率为22. 22%

高于B 组的9. 23%(P<0. 05)。结论:甲泼尼龙治疗儿童RMMP 的临床疗效和安全性均优于地塞米松。

Abstract

Objective: To observe the difference of clinical efficacy and safety of dexamethasone vs. methylprednisolone in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 128 children with RMPP were randomly divided into group A (n =63) and group B (n =65). On the basis of conventional treatment

group A was given dexamethasone 0. 35 mg/ (kg·d)

intravenously once a day

and group B was given methylprednisolone 2 mg/ (kg·d)

2 times a day for intravenous drip. Two groups were both treated for 5 days. The clinical efficacy

improvement of clinical symptoms

plasma myocardial enzyme profile such as creatine kinase (CK)

creatine kinase isoenzyme (CK-MB)

lactate dehydrogenase (LDH)

serum inflammatory factors such as tumor necrosis factor-α (TNF-α)

interleukin-6 (IL-6)

and gamma-interferon (IFN-γ) and adverse drug reactions between the two groups were compared. Results: The total effective rate in group B was 86. 15%

which was higher than that in group A (71. 43%) (P< 0. 05). Time that symptoms disappeared of group B was much shorter than that in group A

such as fever (4. 55 ±1. 05) d vs. (5. 24± 1. 12) d

cough (6. 67±1. 12) d vs. (7. 23±1. 57) d

lung rales (10.76±1.47) d vs. (11.63±2.52) d and X-ray lung shadow (7.97± 1. 03) d vs. (8. 43±1. 26) d

and the differences were all statistically significant (all P<0. 05). After treatment

the levels of CK

CK-MB

LDH

TNF-α

IL-6 and IFN-γ of the two groups were all decreased compared with before treatment (P <0. 05)

and the decrease in group B was more significant than that in group A (P<0. 05). The incidence of adverse drug reactions in group A was 22. 22%

which was higher than 9. 23% in group B (P<0. 05). Conclusion: The results of this study show that methylprednisolone is better than dexamethasone in clinical efficacy and safety in children with RMPP.

关键词

地塞米松甲泼尼龙难治性肺炎支原体肺炎儿童疗效安全性

Keywords

examethasonemethylprednisolonerefractory Mycoplasma pneumoniae pneumoniachildrenefficacysafety

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