Clinical Study Of Vitamin D Combined With Azithromycin On Mycoplasma Pneumoniae Pneumonia In Children

Objective: In the clinical,Vitamin D combined with azithromycin on Mycoplasma pneumoniae pneumonia in children that were observed the clinical efficacy and safety,then detect the relevant indicators to discuss the mechanism of its action,so as to provide evidence and guidance for clinical medication.Methods: 100 cases of children with mycoplasma pneumonia from August 2018 to August 2019 in Zunyi Maternal and Child Health Hospital department of pediatrics were selected and randomly divided into the control group and the observation group,50 cases in each group.At the same time,50 cases of healthy children who underwent physical examination in the child healthcare department of the same hospital were randomly selected as the health group.Patients in the control group were treated with azithromycin and routine treatment,based on that,patients in the observation group were added the application of Vit D treatment.By monitoring the changes of myocardial enzyme,blood calcium,liver function,kidney function,urine routine and observing the presence or absence of adverse reactions before and after treatment to detect the safety of Vit D.After 1 week of treatment,the clinical efficacy of two groups was evaluated and compared.The children’cough disappearing time,anhelation disappearing time,pyretolysis time,the pulmonary rales disappeared time and hospitalization time of the two group were observed,and the statistical data were compared.At the same time,fasting venous blood was collected from the healthy group during physical examination and fasting venous blood was collected from the observation group and the control group before and after 1 week of treatment.Serum 25(OH)D level was determined by liquid chromatography tandem mass spectrometry,serum LL-37,IL-6,IL-10,IFN-γ,TNF-α and VEGF level were determined by ELISA,IκB-α m RNA expression was determined by q RT-PCR.And the statistical data were compared.Results: After 1 week of treatment,serum calcium level in the observation group was higher than that before treatment(P<0.05),but within the normal range.And there was no significant difference in the incidence of liver and kidney function,myocardial enzyme,urine routine and adverse reaction in observation group before and after treatment(P>0.05).The cough,anhelation,pulmonary rales,fever time and hospitalization time in the observation group were less than those in the control group(P<0.05).After 1 week of treatment,the observation group was significantly effective in 29 cases,effective in 17 cases,ineffective in 4 cases,while the control group was significantly effective in 19 cases,effective in 23 cases,ineffective in 8 cases,and the clinical efficacy of the observation group was better than that of the control group(P=0.039).Before treatment,serum 25(OH)D levels in the observation group and the control group were lower than those in the healthy group(P<0.05).After 1 week of treatment:serum 25(OH)D,LL-37,IL-10 levels and IκB-αm RNA expression in the observation group were significantly higher than that before treatment(P<0.05);There were no statistically significant differences in serum 25(OH)D,LL-37,IL-10 levels or IκB-α m RNA expressionl in the control group before and after treatment(P>0.05);Both groups had lower serum IL-6、IFN-γ、TNF-α levels than before treatment(P<0.05),and the decrease level in the observation group were significantly higher than that in the control group(P<0.05).Conclusion:(1)The treatment of vitamin D combined with azithromycin on MPP in children is safety.(2)The treatment of vitamin D combined with azithromycin on MPP in children is effective.(3)The mechanism of Vit D combined with azithromycin on MPP in children may be associated with increased the level of LL-37 to enhance their antibacterial effect and regulated the expression of IκB-α to inhibit its inflammatory pathway.