目的了解肺炎支原体(MP)临床分离株对大环内酯类抗生素的耐药情况,观察蛭丹化瘀口服液对耐药MP菌株感染致肺炎支原体肺炎(MPP)的临床疗效。方法选取2006年9月-2007年10月北京友谊医院儿科住院的确诊为MPP患儿65例,在常规肺炎治疗原则的基础上,根据是否服用蛭丹化瘀口服液分为治疗组和对照组。治疗组加用蛭丹化瘀口服液,每次0.5mL·kg^-1,3次·d^-1;对照组仅常规治疗。患儿入院后取咽拭子标本行MP分离、鉴定和培养,2组分离出耐药株30例,其中治疗组18例,对照组12例。观察2组耐药MPP患儿住院天数、发热时间、咳嗽及肺部啰音变化等。结果治疗组住院天数、热程、咳嗽减轻、肺部啰音消失时间分别为(10.1±3.5)d、(10.0±4.3)d、(12.4±4.5)d、(13.0±5.2)d,对照组分别为(11.1±2.5)d、(11.0±5.0)d、(12.5±6.0)d、(14.5±6.0)d;2组患儿年龄、住院天数、热退时间、咳嗽减轻时间比较差异均无统计学意义(Pa〉0.05),而啰音消失时间比较差异有统计学意义(P〈0.05)。结论临床MP分离株对大环内酯类抗生素耐药较严重。蛭丹化瘀口服液对耐药MPP有一定疗效。
Objective To investigate the resistance of clinical isolates of mycoplasma pneumoniae(MP) to macrolide antibiotics,and observe the efficacy of zhidanhuayu oral solution treatment for the patients with drug-resistant mycoplasma pneumoniae pneumonia (MPP).Methods Sixty-five patients with MPP were collected in Beijing Friendship Hospital during Sep.2006 to Oct. 2007,and they were randomly divided into 2 groups based on the use of traditional medicine zhidanhuayu oral solution produced by adding on standard treatment.The patients in treatment group were received combination therapy with zhidanhuayu oral solution(each 0.5 mL·kg^-1,3 times a day), while the patients in control group without it.After hospitalized,throat swab was collected from patients with drug-resistant MPP to isolate,MP was identify and cultured,2 group resistant strains were isolated from 30 cases,18 cases in treatment group and 12 cases in control group,and the difference of efficacy endpoints such as hospitalized days,time duration of fever,cough and lung rale were observed between 2 groups.Results The hospitalized days,time duration of fever,time duration of cough,disappear time of lung rale in treatment group and control group [(10.1±3.5) d vs(11.1±2.5) d,(10.0±4.3) d vs(11.0±5.0) d,(12.4±4.5) d vs(12.5±6.0) d,(13.0±5.2) d vs(14.5±6.0) d, respectively],there was no significant difference between 2 groups with respect to age,hospitalized days,disappear time of fever,relieved time of cough(Pa〉0.05),the disappear time of lung rale of the patient with drug-resistant MP in treatment group was shorter than that in control group(P〈0.05).Conclusion There are severe drug-resistance for clinical isolates of MP to macrolide antibiotic,zhidan-huayu oral solution plays an important role on MPP.