ABSTRACT
Objective To investigate the clinical,laboratory and imaging characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) in different age groups.Methods One hundred and sixty-four children whose ages were 1 month to 14 years old with MPP hospitalized at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine in 2017 were enrolled as study objects.All children were classified into 2 groups:1 month to 3 year-old group (46 cases) and ＞ 3 to 14 year-old group (118 cases).The clinical features,main laboratory and imaging findings of 2 groups were retrospectively analyzed and compared.Results (1) Compared with 1 month to 3 year-old group,＞ 3 to 14 year-old group had more patients with fever [97.5％ (115/118 cases) vs.84.8％ (39/46 cases)],longer duration of fever [48.3％ (57/118 cases) vs.23.9％ (11/46 cases)] and higher fever [83.1％ (98/ 118 cases) vs.52.2％ (24/46 cases)],but less patients with wheezing [2.5％ (3/118 cases) vs.43.5％ (20/46 cases)],shortness of breath and dyspnea [0.8％ (1/118 cases) vs.15.2％ (7/46 cases)],dry rale [1.7％ (2/118 cases) vs.60.9％ (28/46 cases)] and wet pulmonary rale [50.0％ (59/118 cases) vs.69.6％ (32/46 cases)],and the differences were statistically significant (all P ＜ 0.05).(2) The increase of platelet count,creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in 1 month to 3 year-old group of MPP [316.0 (229.3,372.3) × 109/L,25.70 (17.70,31.98) U/L,346.5 (310.3,388.3) U/L] were more common than those in ＞ 3 to 14 year-old group [266.0 (205.8,317.8) × 109/L,21.50 (15.75,28.00) U/L,303.0 (173.0,352.0) U/L],while the increase of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in ＞ 3 to 14 year-old group [12.66(9.16,19.44) mg/L,23.00(17.75,29.00) mm/1 h] were more common than those in 1 month to 3 year-old group[2.46 (0.54,11.63) mg/L,14.00 (10.00,20.25) mm/1 h],and there were significant statistical differences (all P ＜ 0.05).(3) The MPP imaging features of children in different age groups were diverse.In 1 month to 3 year-old group,the double lung involvement [80.4％ (37/46 cases)] was more obvious than that in ＞3 to 14 year-old group [55.9％ (66/118 cases)],and the difference was statistically significant (P ＜ 0.05).The lesions of 1 month to 3 year-old group were more common in lobular pulmonary [82.6％ (38/46 cases)],while in ＞ 3 to 14 year-old group,the radiographic findings were predominant with consolidation in the segment or lobe of the lung [33.1％ (39/118 cases)],and the difference was statistically significant (P ＜ 0.01).Conclusions Younger than 3 year-old children with MPP are prone to wheezing,shortness of breath,dyspnea and lung rale,while the rise of CK-MB and LDH is common.Imaging is mainly involved in double lung involvement and pulmonary lobule infiltration.The older the children with MPP are,the longer the fever duration is,and more common is the higher fever.The older the children,the more more easily they have the relative increase of CRP and ESR,and at the same time they are more likely to have the consolidation of the lung segment or lobe.
ABSTRACT
Objective To study the effect of atomized inhalation of pulmicort respules combined with tulobuterol in the treatment of children with wheezing pneumonia and its influence on serum inflammatory factors.Methods 90 children with asthmatic bronchopneumonia were selected,and they were randomly divided into observation group and control group,45 cases in each group.The control group received routine western medicine and atomized inhalation of ambroxol hydrochloride.The observation group was treated with pulmicort respules inhalation combined with tulobuterol paste service on the basis of the control group.After 1 course of treatment,the efficacy was evaluated.The improvement of clinical symptoms,clinical efficacy,serum cytokine level,inflammatory index and adverse reaction were compared between the two groups.Results The disappearance time of clinical signs such as shortness of breath,cough,wheezing and pulmonary rales in the observation group were significantly shorter than those in the control group [(7.58±0.72)d,(8.42±1.33)d,(5.66±0.74)d,(7.76±0.75)d vs.(4.21±0.29)d,(2.59±0.71)d,(3.41±0.69)d,(5.29±0.71)d,P0.05).The ECP and Eos in the peripheral blood of the two groups were significantly lower than those before treatment(t=8.363,4.307,13.431,12.949,all P0.05).After treatment,the levels of IL-4,IL-6 and IL-10 were significantly decreased and the IFN-γ level was significantly higher than before treatment(t=17.216,20.051,17.891,15.417,32.724,26.709,28.112,26.708,all P<0.05).The levels of inflammatory cytokines in the peripheral blood of the observation group were significantly better than those of the control group(t=9.306,4.150,5.117,4.124,all P<0.05).No serious adverse events occurred in the two groups during the treatment.Conclusion Pulmicort respules combined with tulobuterol is effective in the treatment of children with wheezing pneumonia.It can relieve the symptoms of cough and wheezing.The mechanism may be related to the imbalance of Th1/Th2 imbalance and the reduction of airway inflammation.
ABSTRACT
Objective To investigate the clinical efficacy of Qingfeihuatan oral solution in the treatment ofchildren with chronic cough.Methods According to the digital table,a total of 116 patients with cough variantasthma induced by chronic cough were randomly divided into control group and observation group,each group had58 cases.The two groups were given budesonide and formoterol fumarate powder for treatment,on this basis,theobservation group added Xiao'er Qingfeihuatan oral solution,the two groups were continuously treated for 4 weeks.Thechanges of lung function indicators,clinical efficacy and adverse reaction etc were observed.Results Aftertreatment,the clinical total effective rate of the observation group was 94.8％,which of the control group was 77.6％,the difference was statistically significant (x2 =3.625,P ＜ 0.05).The lung function indicators of FEV,FEV1 andFEV1/FEV in the two groups had statistically significant differences between before and after treatment (all P ＜0.05),but the pulmonary function indicators of FEV,FEV1 and FEV1/FEV in the observation group compared withthe control group had statistically significant differences (all P ＜ 0.05).The incidence rate of adverse reactions in theobservation group was 13.8％,which in the control group was 15.5％,the difference was not statistically significant(x2 =0.034,P ＞ 0.05).Conclusion On the basis of routine treatment,Qingfeihuatan oral solution in the treatmentof children with chronic cough can significantly improve the pulmonary function of patients,improve the clinicaltreatment effect,and has good safety and great clinical significance.