| BackgroundMycoplasma Pneumoniae?MP?is one of the common microorganisms in children with respiratory infections.In the past,Mycoplasma Pneumoniae Pneumonia?MPP?was considered a self-limiting disease.After active treatment with macrolide antibiotics,the condition of the child can be quickly controlled without leaving sequelae in the lungs and outside the lungs.However,in recent years,it has been reported at home and abroad that some children with MPP are still unable to control the condition of anti-MP,and even further aggravated or prolonged,known as Refractory Mycoplasma Pneumoniae Pneum-onia?RMPP?.ObjectivesBy comparing the clinical efficacy of different doses of methylprednisolone in the treatment of Refractory Mycoplasma Pneumoniae Pneumonia in children,the significance of different doses of methylprednisolone in the treatment of Refractory Mycoplasma Pneumoniae Pneumonia was further discussed.MethodApproved by the ethics committee of two hospitals of XuChang central hospital and the first affiliated hospital of XinXiang medical college?see appendix B and appendix C for the approval?,children with Refractory Mycoplasma Pneumoniae Pneumonia admitted to the department of pediatrics of two hospitals from September 2016 to May 2018 who met the inclusion criteria and exclusion criteria were retrospectively selected as the research objects,this thesis has no obvious differences in gender,age and condition of 55cases of children,According to the use of methylprednisolone,40 cases were divided into the conventional-dose group?methylprednisolone 2mg/kg/d?[3],and 15 cases in the shock-dose group?methylprednisolone 10mg/kg/d?[4].Both groups were treated with conventional methods,selects the macrolide drug azithromycin with 10mg/kg/d was used,Intravenous infusion once a day for 7 days,Iv infusion of azithromycin aspartate10mg/kg/d once a day for 7 days after withdrawal for 4 days.and 2 courses of treatment can be repeated for anti-mycoplasma pneumoniae infection treatment[5],and treats the corresponding symptoms?antipyretic,antitussive,antiasthmatic,expectorant,atomized inhalation and other supportive treatments?.On this basis,In the conventional-dose treatment group,a wave of methylprednisolone 2 mg/kg/d was added,2 times/day,and an intravenous infusion was given for 5 days,Prednisone was taken orally for 1mg/kg/d and halved to discontinue for 3 days.The shock-dose treatment group was treated with a methylprednisolone 10mg/kg/d,2 times/day,and an intravenous infusion of 5 days,Prednisone was taken orally for 1mg/kg/d and halved to discontinue for 3 days.According to the results of clinical total effective rate,hospitalization time,heat withdrawal time,cough remission time,laboratory inflammatory indexes?WBC,CRP,LDH?before and after treatment,imaging improvement and adverse reactions.According to two groups of children with clinical total effective rate,length of hospital stay,thermal annealing time,cough easing,laboratory inflammatory indexes such as the total number of White Blood cells?WBC?and C-reactive Protein?CRP?,serum Lactate dehydrogenase?LDH?,and other changes and imaging before and after treatment,and compared the results of hormone application adverse reactions.Result1.The total clinical effective rate:After 3 weeks of treatment,the clinical efficacy showed that there was no statistically difference?P>0.05?between the conventional-dose treatment group?90.0%?and the shock-dose treatment group?93.3%?.2.Hospitalization time:There was no statistically difference?P>0.05?between the conventional-dose treatment group?23.40±1.08 days?and the shock-dose treatment group?22.80±0.94 days?.3.Heat withdrawal time:There was no statistically difference?P>0.05?between the conventional-dose treatment group?8.30±0.76 days?and the shock-dose treatment group?7.87±0.64 days?.4.Cough remission time:There was no statistical difference?P>0.05?between the conventional-dose treatment group?11.33±1.14 days?and the shock-dose treatment group?10.67±1.05 days?.5.Laboratory inflammatory index:After 1 weeks of treatment,there were statistical differences between the shock and conventional dose treatment groups?P<0.05?in WBC,CRP and LDH levels.6.Imaging rate of lung imaging:Chest CT was reexamined after 3 weeks of treatment,the inflammation of 21patients?52.5%?in the conventional-dose group was mostly absorbed while the inflammation of 14 patients?93.3%?in the shock-dose group was mostly absorbed.The difference between the shock-dose treatment group and the conventional-dose treatment group was statistically significant?P<0.05?.7.Hormone adverse reactions:There were no serious adverse events such as peptic ulcer after the application of methylprednisolone among children in the shock-dose treatment group and the conventional-dose treatment group,some mild adverse reaction such as tachycardia,transient hypertension,electrolyte imbalance and hyperglycaemia appeared.the results showed that the incidence of adverse reactions in the shock-dose treatment group was shocker than that of the conventional-dose treatment group,and there was a statistically difference?P<0.05?.Conclusion1.When conventional-dose of methylprednisolone was used to treat RMPP in children,It was equivalent to shock-dose in terms of clinical total effective rate,length of hospitalization,duration of heat retreat and duration of cough remission.2.Shock-dose methylprednisolone was better than conventional-dose treatment in the effect of improving the laboratory inflammatory index?WBC,CRP,LDH?and lung imaging absorption rate.3.In terms of adverse reactions,the safety of conventional-doses of methylpredn isolone in the treatment of children with RMPP was significantly improved. |
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