目的 觀(guān)察孟魯司特鈉聯(lián)合鹽酸丙卡特羅治療兒童難治性支原體肺炎的臨床效果及對(duì)肺功能、血清炎癥因子水平的影響。方法 選取2021年6月—2023年5月在合肥市第八人民醫(yī)院就診的82例難治性支原體肺炎患兒，隨機(jī)分為研究組（42例）和對(duì)照組（40例），對(duì)照組給予常規(guī)治療結(jié)合鹽酸丙卡特羅（口服，每次1片，每天1次）治療，研究組在對(duì)照組基礎(chǔ)上給予孟魯司特鈉（口服，年齡≥6歲者每天1次，每次5 mg，年齡＜6歲者每天1次，每次4 mg）治療。兩組患兒均持續(xù)治療14 d。比較兩組患兒治療效果、病情恢復(fù)時(shí)間、治療前后肺功能指標(biāo)、血清炎癥因子水平的差異，記錄不良反應(yīng)發(fā)生情況。結(jié)果 研究組總有效率（95.24%）顯著高于對(duì)照組（72.50%，P＜0.05）。研究組住院時(shí)間、退熱時(shí)間、止咳時(shí)間、氣喘消失時(shí)間、啰音消失時(shí)間和肺部陰影消失時(shí)間均顯著低于對(duì)照組（P＜0.05）。與治療前相比，兩組患兒治療14 d后一秒用力呼吸容積（FEV1）、用力肺活量（FVC）、最大呼氣中段流量（MMEF）、最大呼氣峰流速（PEF）和FEV1/FVC顯著升高（P＜0.05）；血清白細(xì)胞介素-6 （IL-6）、白細(xì)胞介素-13 （IL-13）、白細(xì)胞介素-17 （IL-17）、腫瘤壞死因子-α（TNF-α）、γ-干擾素（IFN-γ）、C反應(yīng)蛋白（CRP）和降鈣素原（PCT）水平顯著降低（P＜0.05）。且治療后研究組FEV1、FVC、MMEF、PEF和FEV1/FVC顯著高于對(duì)照組（P＜0.05）；血清IL-6、IL-13、IL-17、IFN-γ、TNF-α、CRP和PCT水平顯著低于對(duì)照組（P＜0.05）。兩組不良反應(yīng)發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 孟魯司特鈉聯(lián)合鹽酸丙卡特羅治療兒童難治性支原體肺炎的效果較好，可有效改善患兒肺功能指標(biāo)，降低血清炎癥因子水平，且安全性較高。

Objective To observe the clinical effect of montelukast sodium combined with propacaterol hydrochloride in the treatment of refractory mycoplasma pneumonia in children and its effect on lung function and serum inflammatory factor level. Methods Eighty-two children who attended the Eighth People's Hospital of Hefei City from June 2021 to May 2023 were selected and randomly divided into a study group (42 cases) and a control group (40 cases). The study group was treated with montelukast sodium (oral, five mg once daily for age ≥ six years and four mg once daily for age < six years) on top of the control group. Both groups were treated for 14 d. The treatment effect, recovery time, lung function indexes and serum inflammatory factor levels before and after treatment were compared, and the occurrence of adverse reactions was recorded. Results The total effective rate of the study group (95.24%) was significantly higher than that of the control group (72.50%, P < 0.05). The study group's hospitalization time, fever reduction time, cough suppression time, asthma disappearance time, rales disappearance time and lung shadow disappearance time were significantly lower than those of the control group (P < 0.05). Compared with the pre-treatment period, the one-second expiratory volume (FEV1), expiratory lung capacity (FVC), maximal mid-expiratory flow (MMEF), maximal peak expiratory flow rate (PEF), and FEV1/FVC were significantly higher in the two study groups after 14 d of treatment (P < 0.05); serum interleukin-6 (IL-6), interleukin-13 (IL-13), interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ), Creactive protein (CRP) and procalcitonin (PCT) levels were significantly reduced (P < 0.05). And the FEV1, FVC, MMEF, PEF and FEV1/FVC of the study group were significantly higher than those of the control group after treatment (P < 0.05); serum IL-6, IL-13, IL-17, IFN-γ, TNF-α, CRP and PCT levels were significantly lower than those of the control group (P < 0.05). The difference in the incidence of adverse reactions between the two groups was not statistically significant. Conclusion The effect of montelukast sodium combined with procaterol hydrochloride in the treatment of refractory mycoplasma pneumonia in children is better, which can effectively improve the lung function indexes of the children, reduce the level of serum inflammatory factors, and has higher safety.

R974

合肥市衛(wèi)生健康委應(yīng)用醫(yī)學(xué)研究項(xiàng)目（Hwk2020yb0020）