2020 年第 12 期 第 15 卷

炎琥宁联合甲泼尼龙治疗迁延性肺炎支原体肺炎的效果及对气道炎性反应的影响

Effect of Yanhuning combined with methylprednisolone on patients with persistent mycoplasma pneumoniae pneumonia and airway inflammation reaction

作者：陈颖姜洁王娜娜

英文作者：Chen Ying Jiang Jie Wang Nana

单位：南京医科大学附属淮安第一医院呼吸与危重症医学科223300

英文单位：Department of Respiratory and Critical Care Medicine the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University Jiangsu Province Huai′an 223300 China

关键词：肺炎支原体肺炎；炎琥宁；甲泼尼龙；炎性反应

英文关键词：Mycoplasmapneumoniaepneumonia;Yanhuning;Methylprednisolone;Inflammatoryresponse

• 摘要：

• 目的 探讨炎琥宁联合甲泼尼龙治疗迁延性肺炎支原体肺炎（MPP）的效果及对气道炎性反应的影响。方法 选取南京医科大学附属淮安第一医院2017年8月至2019年7月收治的迁延性MPP患者98例，应用随机数字表法分为观察组和对照组，各49例。对照组患者给予甲泼尼龙治疗，观察组在对照组治疗基础上联合炎琥宁治疗，2组均治疗2周。比较2组患者咳嗽消失时间、发热消失时间、肺部啰音消失时间和X线胸片恢复正常时间以及治疗前后血清和诱导痰液中炎症因子水平的变化。结果 观察组患者的咳嗽消失时间、发热消失时间、肺部啰音消失时间和X线胸片恢复正常时间均显著短于对照组［(6.9±1.1)d比（7.6±1.3）d、(4.2±0.8)d比（4.8±0.9）d、(6.1±1.0)d比（6.8±1.2）d、(9.4±2.0)d比（11.2±2.5）d］，差异均有统计学意义（均P<0.05）。治疗前，2组血清白细胞介素2(IL-2)、IL-4、IL-6和肿瘤坏死因子α(TNF-α)水平以及诱导痰标本中可溶性髓系细胞触发受体1、TNF-α和IL-10水平比较差异均无统计学意义（均P>0.05）；治疗2周后，2组血清IL-2水平均高于治疗前，且观察组高于对照组，血清IL-4、IL-6、TNF-α和诱导痰液中可溶性髓系细胞触发受体1、TNF-α和IL-10水平均低于治疗前，且观察组均低于对照组（均P<0.05）。结论 炎琥宁联合甲泼尼龙治疗迁延性MPP能降低患者血清和诱导痰中炎症因子水平，缓解气道黏膜局部的炎性反应，缩短患者临床症状和体征改善时间。

• Objective To explore the effect of Yanhuning combined with methylprednisolone on the treatment of persistent mycoplasma pneumoniae pneumonia(MPP) and its influence on airway inflammation response. Methods Totally 98 patients with persistent MPP admitted to the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University from August 2017 to July 2019 were selected and randomly divided into observation group and control group, with 49 cases in each group. The control group was treated with methylprednisolone, and the observation group was treated with Yanhuning on the basis of the control group. Both groups were treated for 2 weeks. The disappearance time of cough, fever, pulmonary rales, recovery time of chest X-ray and inflammatory factors in serum and induced sputum were compared between the two groups before and after treatment. Results The disappearance time of cough, fever, pulmonary rales and recovery time of chest X-ray in the observation group were significantly shorter than those in the control group ［(6.9±1.1)d vs (7.6±1.3)d, (4.2±0.8)d vs (4.8±0.9)d, (6.1±1.0)d vs (6.8±1.2)d, (9.4±2.0)d vs (11.2±2.5)d］, the differences were statistically significant (all P<0.05). Before treatment, there were no significant differences in levels of serum interleukin (IL)-2, IL-4, IL-6 and tumor necrosis factor(TNF)-α and the levels of soluble triggering receptor 1, TNF-α and IL-10 in induced sputum between the two groups (all P>0.05); after 2 weeks of treatment, the levels of serum IL-2 in the two groups were higher than those before treatment and that in the observation group was higher than that in the control group, and the levels of serum IL-4, IL-6, TNF-α and the levels of soluble triggering receptor 1, TNF-α and IL-10 in induced sputum were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). Conclusion Yanhuning combined with methylprednisolone in the treatment of persistent MPP can reduce the levels of inflammatory factors in patient′s serum and induced sputum, relieve the local inflammatory response of the airway mucosa, and shorten the time to improve the clinical symptoms and signs of the patient.