盐酸氨溴索联合阿奇霉素治疗儿童支原体肺炎的疗效及对患儿免疫功能、炎性因子的影响

The Efficacy of Ambroxol Hydrochloride with Azithromycin in the Treatment of Mycoplasma Pneumoniae Pneumonia in Children and Its Effects on Immune Function and Inflammatory Factors in Children

摘要: 目的：观察氨溴索联合阿奇霉素治疗肺炎支原体肺炎(MPP)的疗效。方法：将2019年1月至2023年1月住院治疗的MPP患儿100例分为对照组(50例)和观察组(50例)。对照组给予阿奇霉素联合盐酸氨溴索1~3岁7.5 mg/次、≥3岁15 mg，观察组给予阿奇霉素联合盐酸氨溴索1~3岁15 mg/次、≥3岁30 mg，疗程1周。对比两组临床疗效、体温正常、咳嗽消失与肺部啰音消失时间，肺功能指标，流式细胞术检测血清CD3⁺、CD4⁺、CD4⁺/CD8⁺水平，酶联免疫吸附试验(ELISA)检测血清定降钙素原(PCT)、白细胞介素-6 (IL-6)及反应蛋白(CRP)，记录不良反应。结果：观察组总有效率高于对照组(90.0% vs 74.0%) (χ² = 4.336, P = 0. 037)。观察组体温正常、咳嗽消失与肺部啰音消失时间均短于常规剂量组(t = 15.53, 17.40, 18.78, P < 0. 001)。治疗后观察组患儿MMF、PEF、PEmax及PImax高于对照组(t = 9.410, 23.180, 6.118, 3.440, P < 0. 001)。观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平高于对照组(t = 5.211, 8.114, 17.650, P < 0.001)。治疗后观察组PCT、IL-6及CRP水平低于对照组(t = 8.485, 4.518, 26.270, P < 0. 001)。两组间不良反应总发生率无差异(χ² = 0.122, P > 0.05)。结论：与常规盐酸氨溴索剂量相比，大剂量盐酸氨溴索临床疗效更佳，提高免疫功能，抑制炎症反应效果更为显著，且不增加不良反应发生率。

Abstract: Objective: To observe the efficacy of ambroxol combined with azithromycin in the treatment of mycoplasma pneumoniae pneumonia (MPP). Method: 100 children with MPP from January 2019 to January 2023 were divided into control group (50 cases) and observation group (50 cases). The control group was given azithromycin combined with ambroxol hydrochloride for 1~3 years 5 mg/time, ≥ 3 years old 15 mg, while the observation group was given azithromycin combined with ambroxol hydrochloride 15 mg/time for 1~3 years old, ≥ 3 years old 30 mg, for one week. The clinical efficacy, normal body temperature, disappearance time of cough and lung rales, lung function indicators were compared between two groups. Flow cytometry was used to detect serum CD3⁺, CD4⁺, CD4⁺/CD8⁺ levels. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum procalcitonin (PCT), interleukin-6 (IL-6), and reactive protein (CRP) levels. The adverse reactions were recorded. Results: The effective rate of the observation group was higher than that of the control group (90.0% vs 74.0%) (χ² = 4.336, P = 0.037). The recovery time of body temperature, disappearance time of cough, and disappearance time of pulmonary rales in the observation group were shorter than that of the conventional dose group (t = 15.53, 17.40, 18.78, P < 0.001). After treatment, the lung function indicators of both groups of children increased. The MMF, PEF, PEmax, and PImax of the observation group were higher than those of the control group (t = 9.410, 23.180, 6.118, 3.440, P < 0.001). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in both groups of children increased, and the observation group was higher than the control group (t = 5.211, 8.114, 17.650, P < 0.001). After treatment, the levels of serum inflammatory factors PCT, IL-6, and CRP1 in both groups of children decreased, and the observation group was lower than the control group (t = 8.485, 4.518, 26.270, P < 0.001). The incidence of adverse reactions of two groups was not significant different (χ² = 0.122, P > 0.05). Conclusion: High-dose ambroxol hydrochloride has better clinical efficacy, improves immune function, and has a more significant effect on inhibiting inflammatory reactions, without increasing the incidence of adverse reactions.