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Objective To analyze the clinical characteristics and risk factors of myocardial damage in children with mycoplasma pneumonia in Qinghai area, and to provide evidence for clinical diagnosis and treatment. Methods A total of 328 children diagnosed with mycoplasma pneumonia in Qinghai region from June 2016 to June 2020 were selected as the research subjects. According to whether they were complicated with myocardial damage, they were divided into the control group (no myocardial damage, n=185) and the experimental group (complicated with myocardial damage, n=143). The data of the children were collected by using a questionnaire made by our hospital. These included gender, age, fever duration, initiation time of macrocyclic esters and fever degree, etc., and the levels of CK-MB, CK, CTNNI, NT-proBNP, CRP, LDH and RDW were determined. RESULTS: There were no significant differences in age, gender and complications between the two groups (P>0.05). There were statistically significant differences in the use time, fever duration and fever degree between the two groups (P<0.05). In terms of laboratory indicators, there were statistically significant differences in the levels of CK-MB, CK, cTNnI, NT-probNP, CRP, LDH and RDW between the two groups (P<0.05).Logistic regression analysis showed that the duration of fever (OR=3.105), the start time of macrolides (OR=1.457), the degree of fever (OR=2.495), CRP(OR=1.853) and RDW(OR=1.358) were the risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area (P<0.05). Conclusion The duration of fever, the initiation time of macrolide drugs, the degree of fever, CRP and RDW are independent risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area. The early use of macrolide drugs can prevent myocardial damage, improve the treatment effect and improve the prognosis of children.
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BACKGROUND: The aim of this study was to evaluate the effect of lung ultrasound on bronchoalveolar lavage in the treatment of mycoplasma pneumonia in children. METHODS: Thirty children with mycoplasma pneumonia who were treated with medication and bronchial lavage were selected. We collected the results of laboratory and imaging examinations after admission, and the changes in lung consolidation area were examined by ultrasound before, immediately upon completion, and at 1, 3, and 7 days after bronchoalveolar lavage. The effective factors affecting bronchial lavage were analyzed through logistic regression. RESULTS: Univariate regression analysis showed significant differences in the lung consolidation area at admission, before, immediately upon completion, and at 1 and 7 days after lavage, as well as in the disease course and atelectasis (or not). Multivariate analysis showed that there were statistical differences in the lung consolidation area at admission, atelectasis (or not), and disease course: lung consolidation area at admission [odds ratio (OR): 2.31512, 95% confidence interval (CI): (0.00182, 0.031775), P=0.029474], atelectasis [OR: 2.695742, 95% CI: (0.079281, 0.597218), P=0.012629], and disease course [OR: -2.43347, 95% CI: (-0.02568, -0.00211), P=0.022773]. CONCLUSIONS: Lung ultrasound can evaluate the effect of bronchial lavage through lung consolidation and atelectasis, which can provide a reference for clinical treatment.
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Objective:To investigate the clinical efficacy of Loulu Shengma Tang combined with azithromycin in the treatment of pediatric mycoplasma pneumoniae pneumonia（MPP） with obstruction of lung by pathogenic heat， and its effect on inflammatory factors， treg and Foxp3 mRNA. Method:Totally 274 children with MPP were divided into observation group （137 cases） and control group （137 cases）. Observation group was treated with Loulu Shengma Tang combined with azithromycin dry suspension， while control group was treated with azithromycin dry suspension alone. The changes of traditional Chinese medicine（TCM） syndrome score of pathogenic-heat obstruction in the lung， serum inflammatory cytokines ［interleukin-6 （IL-6），interleukin-10 （IL-10），tumor necrosis factor-α （TNF-α），C-reactive protein （CRP）］， CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were observed after treatment. The clinical efficacy and the incidence of adverse reactions were compared between two groups. Result:The total effective rate of observation group was 94.16%（129/137） after treatment， which was significantly higher than 77.37% （106/137）of observation group （P<0.05）. The disappearance times of cough， lung rale， fever and lung shadow in observation group were shorter than that in control group （P<0.05）. After treatment， TCM syndrome score of pathogenic-heat obstruction in lung was significantly higher than those in control group （P<0.05）， serum IL-6， IL-10， TNF-α and CRP levels in observation group were significantly lower than those in control group （P<0.05， P<0.01）， while CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were significantly higher than those in control group （P<0.05）. The incidence of adverse reactions in observation group was 7/137 （5.11%）， which was significantly lower than 16/137 （11.68%） in control group. Conclusion:The clinical efficacy of Loulu Shengma Tang combined with azithromycin dry suspension in the treatment of pediatric MPP and its effect on serum inflammatory factors （IL-6， IL-10， TNF-α， CRP）， regulatory T cells and Foxp3 mRNA expressions were better than those of azithromycin dry suspension alone. The incidence of adverse reactions of Loulu Shengma Tang was lower than that of azithromycin dry suspension alone.
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This study explored the effect of pidotimod combined with azithromycin on children with mycoplasma pneumonia and the expression of interleukin-10 (IL-10) and granulocyte colony-stimulating factor (G-CSF) in serum. The clinical data of 149 children with mycoplasma pneumonia from May 2014 to May 2018 in Zhangqiu District Maternal and Child Health Care Hospital were collected. Among them, 70 children treated with azithromycin sequential therapy were the control group, and 79 children treated with the combination of pidotimod and azithromycin were the observation group. Double antibody sandwich enzyme-linked immunosorbent assay (ELISA) was used to determine the expression levels of IL-10 and G-CSF in serum before and after treatment. Pearson's correlation coefficient was used to analyze the correlation between IL-10 and G-CSF in serum. The total effective rate in the observation group (94.94%) was significantly higher than that in the control group (81.43%) (P<0.05). There was no significant difference in the expression levels of IL-10 and G-CSF between the two groups before treatment (P>0.05). The expression levels of IL-10 and G-CSF in the two groups after treatment were significantly lower than those before treatment (P<0.05). After treatment, the expression levels of IL-10 and G-CSF in serum in the observation group were significantly lower than those in the control group. There was a significant positive correlation between the expression levels of IL-10 and G-CSF before and after treatment in the observation group (P<0.05), and a significant positive correlation between the expression levels of IL-10 and G-CSF before and after treatment in the control group (P<0.05). Compared with sequential treatment with azithromycin alone, pidotimod combined with azithromycin significantly reduced the expression levels of IL-10 and G-CSF in serum of children with mycoplasma pneumonia, improved the curative effect and reduced the occurrence of adverse reactions, which has high application value in clinic.
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WHAT IS KNOWN AND OBJECTIVE: An increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta-analysis. METHODS: Randomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data. RESULTS: A total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA. WHAT IS NEW AND CONCLUSION: Yanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.
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Azithromycin/therapeutic use , Drugs, Chinese Herbal/therapeutic use , Pneumonia, Mycoplasma/drug therapy , Bayes Theorem , Child , Humans , Network Meta-Analysis , Randomized Controlled Trials as TopicABSTRACT
Objective To investigate the effect of serum high sensitive C reactive protein (hs-CRP) level on the curative effect of azithromycin in treatment of mycoplasma pneumonia in children.Methods The 68 cases of children with mycoplasma pneumonia in Maternal and Child Health Care Hospital of Chongzhou were selected as the research objects from June 2013 to June 2016.All the children were treated with 10mg/kg azithromycin daily.The clinical symptoms,chest X-ray changes and adverse reactions of children during treatment were observed and the level of hs-CRP was determined by latex immunoassay.Results The mean value of serum hs-CRP was (19.06 ± 3.01),and the median of serum hs-CRP was 12.92mg/L,which were higher than the normal upper limit value of 10mg/L.Children were divided into high hs-CRP group and low hs-CRP group by the median value of hs-CRP.There were no significant differences in the age,sex,course of disease and body temperature between the two groups (P ＞ 0.05).The overall effective rate of low hs-C RP group was 94.12％,which was significantly higher than that of high hs-C RP group at 76.47％ (x2 =4.221,P =0.040).The duration of cough,wheezing and lesion absorption time in high hs-CRP group were longer than those in the low hs-CRP group (P ＜0.05).But no significant difference was observed in time of fever,hospitalization time,the incidence of adverse reactions between two groups (P ＞0.05).Conclusion hs-CRP plays an important role in children's mycoplasma pneumonia,and the clinical effect of azithromycin is much better on the patients with low level of hs-CRP.
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Objective To investigate the effect of serum high sensitive C reactive protein (hs-CRP) level on the curative effect of azithromycin in treatment of mycoplasma pneumonia in children.Methods The 68 cases of children with mycoplasma pneumonia in Maternal and Child Health Care Hospital of Chongzhou were selected as the research objects from June 2013 to June 2016.All the children were treated with 10mg/kg azithromycin daily.The clinical symptoms,chest X-ray changes and adverse reactions of children during treatment were observed and the level of hs-CRP was determined by latex immunoassay.Results The mean value of serum hs-CRP was (19.06 ± 3.01),and the median of serum hs-CRP was 12.92mg/L,which were higher than the normal upper limit value of 10mg/L.Children were divided into high hs-CRP group and low hs-CRP group by the median value of hs-CRP.There were no significant differences in the age,sex,course of disease and body temperature between the two groups (P ＞ 0.05).The overall effective rate of low hs-C RP group was 94.12％,which was significantly higher than that of high hs-C RP group at 76.47％ (x2 =4.221,P =0.040).The duration of cough,wheezing and lesion absorption time in high hs-CRP group were longer than those in the low hs-CRP group (P ＜0.05).But no significant difference was observed in time of fever,hospitalization time,the incidence of adverse reactions between two groups (P ＞0.05).Conclusion hs-CRP plays an important role in children's mycoplasma pneumonia,and the clinical effect of azithromycin is much better on the patients with low level of hs-CRP.
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Objective To investigate the effect of gamma globulin combined with glucocorticoid pulse therapy in the treatment of children with refractory mycoplasma pneumonia in CRP and safety.Methods 46 cases of children with refractory mycoplasma pneumonia from February 2012 to February 2016 were selected and randomly divided into the control group and experimental group,23 cases in each group.On the basis of the regular treatment,the control group was given azithromycin,10mg/kg,qd,intravenous drip,on the basis of the control group treatment,the experimental group was treated with methylprednisolone 2mg/kg+human immunoglobulin 400mg/kg,qd,intravenous drip.The levels of serum C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC),therapeutic efficiency and safety were measured before and after treatment.Results After treatment,compared with the control group,the serum levels of CRP、WBC、LC were lower in the experimental group,the difference was statistically significant(P<0.05).The treatment efficiency of the experimental group(91.31％)was significantly higher than that of the control group(65.22％),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The gamma globulin combined with glucocorticoid pulse therapy can significantly reduce the serum levels of CRP,WBC and LC in children with refractory mycoplasma pneumonia,improve clinical efficacy and the safety were good.
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Objective To evaluate the effectiveness and safety of TCM treatment to children with mycoplasma pneumonia. Methods RCTs of trational Chinese medicine in treating children with mycoplasma pneumonia were retrieved. CNKI, Wanfang Database and CBMdisc were searched for Chinese literature, and PubMed, EMbase and Cochrane Library were searched for foreign literature. All searching time was up to May 25, 2012. Data were picked up by two system reviewers individually and evaluation standard of Cochrane was used to evaluate the quality of selected literature. Results A total of 64 RCTs including 6289 cases of children with mycoplasma pneumonia were analyzed. In the improvement of clinical symptoms, among comparison between traditional Chinese medicine and western medicine (RR=1.10, 95%CI:-1.0--1.18) and comparison between traditional Chinese medicine plus western medicine and western medicine (RR=1.14, 95%CI:1.10-1.18), curative effects of treatment group were superior to the control group, P<0.00;For the fever clearance time, among comparison between traditional Chinese medicine and western medicine (RR=-4.26, 95%CI:-8.15--0.37), comparison between traditional Chinese medicine plus western medicine and western medicine (RR=-0.97, 95%CI:-1.27--0.66), curative effects of treatment group were superior to the western medicine group. For the time of the disappearance of cough and pulmonary rales, and the basic X-ray absorption time, curative effects of treatment group were also superior to the control group. Untoward effects in western medicine group were obvious than that of traditional Chinese medicine group. Conclusion TCM could improve and shorten the duration of symptoms of children with mycoplasma pneumonia. However, it is still necessary to be verified with more multi-center, double-blind, large sample randomized controlled trials, since the literature which have been brought into related researches were with low quality.
