Clinical features and treatment of refractory mycoplasma pneumoniae pneumonia unresponded to conventional dose methylprednisolone in children
10.3969/j.issn.1671-8348.2015.06.012
- VernacularTitle:激素常规疗法无效果 RMPP 儿童的临床特点和治疗方案研究
- Author:
Yurong BAI
;
Yuxian HUANG
- Publication Type:Journal Article
- Keywords:
hormone;
methyl prednisolone;
refractory mycoplasma pneumoniae pneumonia;
children
- From:
Chongqing Medicine
2015;(6):752-754
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical manifestations of refractory mycoplasma pneumoniae pneumonia (RMPP)which unresponded to methylprednisolone in the dosage of 2 mg·kg-1 ·d-1 for 3 day.Methods Retrospective analysis was performed on the clinical data of 120 children with RMPP.The patients were divided into effective group and ineffective group according to ini-tial effeet of 2 mg· kg-1 · d-1 methylprednisolone.The elinical manifestations,laboratory examination,radiological features and bronchofibroscopic findings of the children were compared.Results Twenty-eight patients in 120 were poor curative effect after regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 23.3%.There were 10 patients in 28 with mixed infection,ac-counted for 35.7%;13 patients with appeared necrotizing pneumonia,accounted for 46.4%;13 patients with secretion obstruction, accounted for 46.4%;10 patients with endometrium necrosis,accounted for 35.7%.92 patients in 120 were good curative effect af-ter regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 76.7%.There were 5 patients in 92 with mixed infection, accounted for 5.4%;10 patients with secretion obstruction,accounted for 10.9;5 patients with secretion obstruction,accounted for 5.4%.The difference was statistically significant (P <0.05).There were correlation between effect of hormone therapy and the levels of WBC,N,hs-CRP,LDH,PCT,IL-6,IL-8,LP,SF,D-dimmer.Multiple factors analysis showed that N,hs-CRP,LDH,IL-8, IL-6 were independent risk factors influence the effect of regular hormone therapy (P <0.05).The effective were improved after in-creasing hormone doses or share ivig.Antibiotic use days in effective group was obviously lower than that in ineffective group,.The difference was statistically significant (P <0.05).Duplex control antibiotics use ratio in ineffective group was significantly higher than that in effective group.The difference was statistically significant (P <0.05).Conclusion Treatment with 2 mg·kg-1 ·d-1 methvlprednisolone could improve clinical symptoms and radiological manifestations of most children with RMPP quickly.But it may be ineffective in some situations such as N,hs-CRP,LDH,IL-8 and IL-6.
