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多西环素治疗 8 岁以下儿童大环内酯类药物无反应性肺炎支原
体肺炎的临床观察
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李珊珊 ，郑吉善 ，陈燕燕 ，沈珑慧 （1.宁波大学附属妇女儿童医院药剂科，浙江 宁波 315012；2.宁波大学
附属妇女儿童医院儿科，浙江 宁波 315012）
中图分类号 R969.3；R978.1 文献标志码 A 文章编号 1001-0408（2025）04-0464-05
DOI 10.6039/j.issn.1001-0408.2025.04.13
摘 要 目的 探讨多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎（MUMPP）的疗效与安全性。方法 回
顾性收集2023年1月1日至12月31日宁波大学附属妇女儿童医院收治的8岁以下MUMPP患儿资料，根据不同抗感染治疗方案
分为多西环素组（44例）、多西环素联合甲泼尼龙组（35例）、阿奇霉素联合甲泼尼龙组（35例）。多西环素组患儿给予盐酸多西环
素肠溶胶囊；多西环素联合甲泼尼龙组患儿给予盐酸多西环素肠溶胶囊+注射用甲泼尼龙琥珀酸钠；阿奇霉素联合甲泼尼龙组患
儿给予注射用阿奇霉素+注射用甲泼尼龙琥珀酸钠；3组疗程均为10 d。比较3组患儿的退热率、退热时间、肺部感染吸收好转率，
记录其住院期间及出院后5个月内的不良反应发生情况。结果 多西环素组、多西环素联合甲泼尼龙组患儿治疗后48、72 h的退热
率及肺部感染吸收好转率均显著高于阿奇霉素联合甲泼尼龙组，退热时间显著短于阿奇霉素联合甲泼尼龙组（P＜0.05），而多西环
素组与多西环素联合甲泼尼龙组比较，差异无统计学意义（P＞0.05）。3组患儿住院期间及出院后5个月内的皮疹、呕吐、腹痛、腹泻
及转氨酶升高的发生率比较，差异均无统计学意义（P＞0.05）；使用多西环素的患儿均未出现牙齿发黄、牙釉质发育不良。结论 多
西环素用于8岁以下儿童MUMPP的疗效和安全性均较好；辅助使用低剂量糖皮质激素并不一定能带来明显的额外疗效。
关键词 多西环素；大环内酯类药物无反应性肺炎支原体肺炎；儿童；疗效；安全性
Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae
pneumonia in children under 8 years of age
LI Shanshan ，ZHENG Jishan ，CHEN Yanyan ，SHEN Longhui（1. Dept. of Pharmacy， Women and Children’s
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Hospital Affiliated to Ningbo University， Zhejiang Ningbo 315012， China；2. Dept. of Paediatrics， Women and
Children’s Hospital Affiliated to Ningbo University， Zhejiang Ningbo 315012， China）
ABSTRACT OBJECTIVE To investigate the efficacy and safety of doxycycline in the treatment of macrolide-unresponsive
Mycoplasma pneumoniae pneumonia （MUMPP） in children under 8 years of age. METHODS The medical records of children with
MUMPP admitted to the Women and Children’s Hospital Affiliated to Ningbo University were collected from January 1st， 2023 to
December 31st， 2023. They were divided into doxycycline group （44 cases）， doxycycline combined with methylprednisolone group
（35 cases）， and azithromycin combined with methylprednisolone group （35 cases） according to the treatment methods.
Doxycycline group was given Doxycycline hyclate enteric-coated capsules； doxycycline combined with methylprednisolone group
was given Doxycycline hyclate enteric-coated capsules and Methylprednisolone sodium succinate for injection； azithromycin
combined with methylprednisolone group was given Azithromycin for injection and Methylprednisolone sodium succinate for
injection. Treatment courses of 3 groups lasted for 10 d. The fever reduction rate， the time of fever reduction and improvement rate
of lung infection absorption were compared among the three groups. The occurrence of adverse drug reactions was recorded during
their hospitalization and followed up within 5 months after discharge. RESULTS The fever reduction rats 48， 72 h after treatment
and improvement rate of lung infection absorption in doxycycline group and doxycycline combined with methylprednisolone group
were significantly higher than azithromycin combined with methylprednisolone group； the time of fever reduction was significantly
shorter than azithromycin combined with methylprednisolone group （P＜0.05）； there was no statistical significance in the difference
between the doxycycline group and the doxycycline combined with methylprednisolone group （P＞0.05）. There was no statistical
significance in the incidence of rash， vomiting， abdominal pain， diarrhea， and elevated transaminases among the three groups
during hospitalization and within 5 months after discharge （P＞0.05）. None of the children treated with doxycycline suffered from
tooth discoloration or enamel hypoplasia. CONCLUSIONS
Doxycycline has good efficacy and safety in therapy of
Δ 基金项目 浙江省医药卫生科技计划项目（No.2023KY1118）；
MUMPP in children under 8 years of age； adjunctive
宁波市医疗卫生高端团队重大攻坚项目（No.2022020405）
＊第一作者 主管药师，硕士研究生。研究方向：抗感染临床药学。 coadministration of low-dose glucocorticoids does not
E-mail：376213594@qq.com necessarily result in significant additional efficacy.
# 通信作者 副 主 任 药 师 。 研 究 方 向 ：药 事 管 理 。 E-mail： KEYWORDS doxycycline； macrolide-unresponsive Mycopla-
nbslh22@163.com sma pneumoniae pneumonia； children； efficacy； safety
· 464 · China Pharmacy 2025 Vol. 36 No. 4 中国药房 2025年第36卷第4期
