Study on therapeutic effect and prognosis of spleen aminopeptide combined with azithromycin in children with mycoplasma pneumoniae infection

WEI Hai-yan; BAO Shi-li; WANG Xiang-min

doi:10.3969/j.issn.1672-8157.2023.05.015

Abstract：Objective:To study the effect of spleen aminopeptide combined with azithromycin on the efficacy and risk factors of poor prognosis in children with MP infection.Methods:In this study,119 patients with MP pneumonia treated in our hospital from February 2020 to January 2023 were taken as the research objects.According to random number table method,the above children were randomly divided into observation group(n = 60,treated with azithromycin combined with spleen aminopeptide)and control groupp(n = 59,treated with azithromycin).Both groups were treated for 7 days.The differences of treatment effect,clinical symptom index,inflammatory index and Th17/Treg level between the two groups were compared,and the risk factors of poor prognosis was nanlyzed.Results:The total effective rate of the control group(66.10%(39/59))was lower than that of observation group(85.00%(49/60)),(P = 0.016).The disappearance time of fever,cough,lung rale and hospital stay in the observation group((5.42±1.62)d,(10.71±2.11)d,(5.44±0.98)d and(12.30±1.72)d,respectively)were lower than those of control group((5.42±1.62)d,(10.71±2.11)d,(5.44±0.98)d and(12.30±1.72)d,respectively),and the difference were statistically significant(all P<0.01).After treatment,TNF-α,IL-β and IL-6 decreased significantly in both groups.IL-1,TNF-α and IL-6 in the observation group((18.27±3.72)ng·L-1,(42.27±3.31)ng·L-1,(39.89±5.37)ng·L-1)were lower than those of control group((20.75±3.73)ng·L-1,(52.17±3.27)ng·L-1,(42.39±5.79)ng·L-1),and the difference were statistically significant(all P<0.01).The level of Th17/Treg in the two groups decreased obviously,and the level of Th17/Treg in the observation group(0.22±0.03)was obviously lower than that of the control group(0.52±0.05).There were significant differences in severity,age,course of disease,immunosuppressive agents,history of asthma and Helicobacter pylori(HP)antibody between children with poor prognosis and those with good prognosis(all P<0.05).Through multivariate analysis,higher severity,younger age,longer course of disease,history of immunosuppressant use,history of asthma and HP antibody were all risk factors for poor prognosis.Conclusion:In the treatment of mycoplasma infection with fucotor assisted azithromycin,the Th17/Treg level of children is significantly reduced and the treatment effect is significant.The treatment scheme should be adjusted in time for children with risk factors of poor prognosis.