复方磺胺甲恶唑治疗儿童百日咳效果观察

王要; 何丽婷; 陈乐园; 潘家华; 张兰

doi:10.16766/j.cnki.issn.1674-4152.003463

复方磺胺甲恶唑治疗儿童百日咳效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003463

安徽医科大学附属省立医院儿科，安徽合肥 230001

基金项目:

安徽省教育厅基金项目 2021jyxm1760

详细信息

通讯作者:
张兰，E-mail：zhanglan1978@ustc.edu.cn

中图分类号: R725.6
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- 被引次数: 0
出版历程
- 收稿日期: 2023-03-12
- 网络出版日期: 2024-05-29

Effect observation of compound sulfamethoxazole in the treatment of pertussis in children

Department of Pediatrics, Anhui Provincial Hospital, Hefei, Anhui 230001, China

摘要

摘要: 目的分析复方磺胺甲恶唑(SMZco)治疗儿童百日咳的疗效及安全性。方法回顾性分析安徽省立医院2018年6月—2022年1月百日咳核酸阳性的百日咳患儿124例，根据治疗方案的不同，分为SMZco组(59例)、大环内酯类组(65例)。比较2组治疗总有效率、夜间咳嗽持续时间、痉挛性咳嗽持续时间、咳嗽后呕吐时间、咳嗽时面红时间、住院时间、药物副作用发生率。结果大环内酯类组显效23例(35.38%)，有效12例(18.46%)，无效30例(46.15%)，总有效35例(53.85%)；SMZco组显效35例(59.32%)，有效16例(27.12%)，无效8例(13.56%)，总有效51例(86.44%)；SMZco组总有效率明显高于大环内酯类组(P＜0.05)。SMZco组住院时间短于大环内酯类组[8.18(6.00, 10.00)d vs. 9.43(7.00, 11.00)d，P＜0.05]；与大环内酯类组相比，SMZco组夜间咳嗽持续时间、痉挛性咳嗽持续时间、咳嗽时面红时间均显著缩短，差异均有统计学意义(P＜0.05)。SMZco组咳嗽后呕吐时间[1.31(0.00, 3.00)d]短于大环内酯类组[1.92(0.00, 4.00)d]，但差异无统计学意义(P＞0.05)。SMZco组消化系统不良反应发生率低于大环内酯类组[6例(10.17%) vs. 16例(24.62%)]，皮疹发生率高于大环内酯类组[10例(16.95%) vs. 2例(3.08%)]，差异均有统计学意义(P＜0.05)。SMZco组肝功能异常发生率低于大环内酯类组[9例(15.81%) vs. 15例(25.40%)]，差异无统计学意义(P＞0.05)。结论 SMZco可以有效治疗儿童百日咳，与大环内酯类药物治疗儿童百日咳相比可以明显提高治疗总有效率，缩短住院时间及临床症状持续时间，降低不良反应发生率。因此，SMZco治疗儿童百日咳具有指导意义, 值得儿科医师关注。
- 复方磺胺甲恶唑 /
- 百日咳 /
- 疗效 /
- 儿童
Abstract: Objective To investigate the clinical efficacy and safety of compound sulfamethoxazole (SMZco) in treating pertussis in children. Methods A retrospective analysis was conducted on 124 children diagnosed with pertussis by polymerase chain reaction (PCR) at Anhui Provincial Hospital between June 2018 and January 2022. The children were divided into two groups: the SMZco group (59 cases) and macrolide group (65 cases). The total effective rate of treatment, duration of nocturnal cough, duration of spastic cough, duration of vomiting after coughing, duration of red face during coughing, duration of hospitalization, and incidence of drug side effects were compared between the two groups. Results Among the macrolide group, 23 cases (35.38%) showed a significant effect, 12 cases (18.46%) were effective, and 30 cases (46.15%) were invalid, resulting in a total effective rate of 53.85%; In the SMZco group, 35 cases(59.32%) were effective, 16 cases (27.12%) were significantly effective, and 8 cases (13.56%) were invalid, resulting in a total effective rate of 86.44%, the effective rate of SMZco group was significantly higher than that of macrolide group (P < 0.05). The hospital stay was 8.18 (6.00, 10.00) days in the SMZco group and 9.43 (7.00, 11.00) days in the macrolide group. The SMZco group had a statistically significant shorter hospital stay than the macrolide group (P < 0.05). Compared to the macrolide group, the duration of nocturnal coughing, spasmodic coughing, and the time of facial redness during cough were significantly shorter in the SMZco group, and the differences were statistically significant (P < 0.05). The vomiting time after cough was 1.31 (0.00, 3.00) days in the SMZco group and 1.92 (0.00, 4.00) days in the macrolide group, but the difference was not statistically significant (P>0.05).The incidence of adverse digestive reactions in the SMZco group was 6 cases (10.17%), which was lower than that in the macrolide group [16 cases (24.62%)], and the incidence of rash was 10 cases (16.95%), which was higher than that in the macrolide group [2 cases (3.08%)], and the differences were statistically significant (P < 0.05). The incidence of abnormal liver function in 9 cases (15.81%) in the SMZco group was lower than that in the macrolide group in 15 cases (25.40%), and the difference was not statistically significant (P>0.05). Conclusion SMZco can effectively treat whooping cough in children, and compared with macrolides in the treatment of whooping cough in children, it can significantly improve the overall effectiveness of treatment, shorten the duration of hospitalization and clinical symptoms, and reduce the incidence of adverse reactions. Therefore, the treatment of childhood pertussis with SMZco is of great significance and deserves the attention of pediatricians.
- Sulfamethoxazole /
- Pertussis /
- Curative effect /
- Children

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表 1 2组百日咳患儿一般情况比较

Table 1. General comparison between two groups of children with pertussis

组别	例数	年龄 [M(P₂₅, P₇₅), 岁]	性别[例(%)]		疫苗接种 [M(P₂₅, P₇₅), 次]	发病时长 [M(P₂₅, P₇₅), d]	咳嗽接触史 [例(%)]	肺部体征阳性 [例(%)]
组别	例数	年龄 [M(P₂₅, P₇₅), 岁]	男	女	疫苗接种 [M(P₂₅, P₇₅), 次]	发病时长 [M(P₂₅, P₇₅), d]	咳嗽接触史 [例(%)]	肺部体征阳性 [例(%)]
大环内酯类组	65	1.54(0.25, 2.00)	34(52.31)	31(47.69)	2.00(1.00, 3.00)	14.43(10.00, 15.00)	17(26.15)	24(36.92)
SMZco组	59	2.12(0.33, 4.42)	32(54.24)	27(45.76)	2.31(2.00, 3.00)	14.49(8.00, 20.00)	19(32.20)	16(27.12)
统计量		1.910^a	0.046^b		1.514^a	-0.606^a	0.545^b	1.361^b
P值		0.059	0.830		0.133	0.545	0.460	0.244
注：^a为Z值，^b为χ²值。

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表 2 2组百日咳患儿治疗总有效率比较[例(%)]

Table 2. Comparison of therapeutic efficacy between two groups of children with pertussis[cases(%)]

组别	例数	显效	有效	无效	总有效
大环内酯类组	65	23(35.38)	12(18.46)	30(46.15)	35(53.85)
SMZco组	59	35(59.32)	16(27.12)	8(13.56)	51(86.44)
注：2组总有效率比较，χ²=15.460，P＜0.001。

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表 3 2组百日咳患儿临床症状持续时间及住院时间比较[M(P₂₅, P₇₅), d]

Table 3. Comparison of duration of clinical cymptoms between two groups of children with pertussis[M(P₂₅, P₇₅), d]

组别	例数	夜间咳嗽持续时间	痉挛性咳嗽持续时间	咳嗽后呕吐时间	咳嗽时面红时间	住院时间
大环内酯类组	65	8.46(7.00, 10.00)	7.35(5.00, 9.00)	1.92(0.00, 4.00)	6.54(5.00, 8.00)	9.43(7.00, 11.00)
SMZco组	59	6.32(6.00, 7.00)	4.93(4.00, 6.00)	1.31(0.00, 3.00)	4.14(4.00, 5.00)	8.18(6.00, 10.00)
Z值		-5.026	-5.268	-1.124	-5.393	-1.780
P值		＜0.001	＜0.001	0.261	＜0.001	0.038

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表 4 2组百日咳患儿药物不良反应发生情况比较[例(%)]

Table 4. Comparison of adverse drug reactions between two groups of children with pertussis[cases(%)]

组别	例数	消化道反应	皮疹	肝功能异常
大环内酯类组	65	16(24.62)	2(3.08)	15(25.40)
SMZco组	59	6(10.17)	10(16.95)	9(15.81)
χ²值		4.422	6.809	1.213
P值		0.036	0.009	0.271

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