多西环素与阿奇霉素联合甲泼尼龙治疗儿童难治性肺炎支原体肺炎的疗效对比研究OA

Objective:To compare the efficacy of doxycycline and azithromycin combined with methylprednisolone in the treatment of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods:A total of 108 children with RMPP diagnosed and treated in our hospital from July 2023 to December 2024 were prospectively selected as study subjects and divided into a control group(n=54)and an observation group(n=54)using a random number table method.The control group was treated with azithromycin combined with methylprednisolone,while the observation group was treated with doxycycline combined with methylprednisolone.The clinical efficacy,time to clinical symptom resolution,length of hospital stay,inflammatory markers[C-reactive protein(CRP),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],pulmonary function[percentage of forced expiratory volume in one second(FEV1)to predicted value,FEV1/forced vital capacity(FVC),percentage of peak expiratory flow(PEF)to predicted value],and incidence of adverse reactions were compared between the two groups.Data mining was performed using Modeler software to analyze the influencing factors of clinical efficacy and adverse reactions in children.Results:The total effective rate in the observation group(90.74%)was higher than that in the control group(75.93%),and the time to clinical symptom resolution(fever,cough,wheeze,and lung rale)and length of hospital stay were shorter in the observation group than in the control group(P<0.05).After treatment,CRP,IL-10,and TNF-α levels were lower in the observation group,while the percentage of FEV1 to predicted value,FEV1/FVC,and percentage of PEF to predicted value were higher in the observation group than in the control group(P<0.05).During treatment,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).According to the automatic classifier model of Modeler software,TNF-α before treatment,percentage of FEV1 to predicted value before treatment,and CRP before treatment were the core driving factors affecting clinical efficacy.According to the Bayesian network model analysis of Modeler software,gender,age,body mass,and the duration of fever before treatment were key factors influencing the incidence of adverse reactions.Conclusion:The efficacy of doxycycline combined with methylprednisolone in the treatment of pediatric RMPP is superior to that of azithromycin combined with methylprednisolone,effectively shortening the duration of clinical symptoms,reducing inflammatory response,and improving lung function.