【摘要】 目的：探讨不同用药方法对儿童传染性单核细胞增多症(IM)合并肺炎支原体(MP)感染的治疗效果。方法：选取2023年6月—2024年6月九江市妇幼保健院收治的IM合并MP感染患儿60例，按照随机数字表法分为红霉素组(n=30)和阿奇霉素组(n=30)，两组患者均进行基础治疗，红霉素组静脉注射阿昔洛韦和红霉素，阿奇霉素组静脉注射阿昔洛韦和阿奇霉素。比较两组临床疗效、实验室指标[丙氨酸氨基转移酶(ALT)、天门氨酸氨基转移酶(AST)、白细胞计数、淋巴细胞计数、T淋巴细胞占比和CD4~+/CD8~+]、症状改善时间和不良反应发生率。结果：治疗7 d后，阿奇霉素组的总有效率高于红霉素组(P<0.05)；治疗7 d后，两组ALT、AST、白细胞计数、淋巴细胞计数、T淋巴细胞占比水平均低于治疗前，CD4~+/CD8~+均高于治疗前(P<0.05)；治疗7 d后，阿奇霉素组ALT、AST、白细胞计数、淋巴细胞计数、T淋巴细胞占比水平均低于红霉素组，CD4~+/CD8~+高于红霉素组(P<0.05)。阿奇霉素组咽峡炎、发热、淋巴结肿胀、眼睑水肿和肝脾肿大症状改善时间均早于红霉素组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论：阿奇霉素联合阿昔洛韦治疗儿童IM合并MP感染的临床效果较好，降低患儿的炎症水平，并缩短了临床症状改善时间，安全性良好。更多还原

【Abstract】 Objective:To explore the therapeutic effects of different medication methods on infectious mononucleosis (IM) complicated with Mycoplasma pneumoniae (MP) infection in children.Method:A total of 60 children with IM complicated with MP infection admitted to Jiujiang Maternal and Child Health Hospital from June 2023 to June 2024 were selected and divided into Erythromycin group (n=30) and Azithromycin group (n=30) according to random number table method.Both groups received basic treatment,and Erythromycin group was given intravenous Acyclovir and Erythromycin.The Azithromycin group received Acyclovir and Azithromycin intravenously.The clinical efficacy,laboratory indexes[alanine aminotransferase (ALT),aspartate aminotransferase (AST),white blood cell count,lymphocyte count,T lymphocyte proportion,CD4~+/CD8~+],symptom improvement time and incidence of adverse reactions were compared between the two groups.Result:After 7 days of treatment,the total effective rate of Azithromycin group was higher than that of Erythromycin group (P<0.05).After 7 days of treatment,ALT,AST,white blood cell count,lymphocyte count,T lymphocyte proportion in two groups were lower than those before treatment,and CD4~+/CD8~+ in two groups were higher than those before treatment (P<0.05).After 7 days of treatment,the ALT,AST,white blood cell count,lymphocyte count,T lymphocyte proportion in Azithromycin group were lower than those in the Erythromycin group,and CD4~+/CD8~+ was higher than that in Erythromycin group (P<0.05).The improvement time of symptoms such as isthmopyra,fever,lymph node swelling,eyelid edema and hepatosplenomegaly in the Azithromycin group was earlier than that in the Erythromycin group (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:Azithromycin combined with Acyclovir in the treatment of children with IM complicated with MP infection has good clinical efficacy,reduces the level of inflammation in children,and shorens the time of clinical symptom improvement,with good safety.更多还原