目的 探討鹽酸洛美沙星滴耳液聯(lián)合頭孢丙烯干混懸劑治療急性化膿性中耳炎患兒的臨床療效。方法 回顧性分析2020年3月—2021年3月在南陽市中心醫(yī)院治療的90例急性化膿性中耳炎患兒的臨床資料，根據(jù)用藥的差別分為對照組和治療組，每組各45例。對照組口服頭孢丙烯干混懸劑，每次15 mg/kg，2次/d；治療組在對照組基礎(chǔ)上給予鹽酸洛美沙星滴耳液，3滴/次，2次/d，滴耳后進(jìn)行約10 min耳浴。兩組均經(jīng)14 d治療。觀察兩組患者臨床療效，比較治療前后兩組臨床癥狀改善時間，血清C反應(yīng)蛋白（CRP）、降鈣素原（PCT）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、水通道蛋白-1（AQP-1）和水通道蛋白-4（AQP-4）水平，及骨導(dǎo)閾值。結(jié)果 治療后，對照組和治療組臨床有效率分別為82.22%和97.78%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。經(jīng)治療，治療組臨床癥狀改善時間均明顯早于對照組（P<0.05）。經(jīng)治療，兩組血清CRP、PCT、IL-6、TNF-α水平均明顯下降（P<0.05），且治療組降低更顯著（P<0.05）。經(jīng)治療，兩組血清AQP-1、AQP-4均明顯增高，且治療組升高更明顯（P<0.05）。經(jīng)治療，兩組各頻率骨導(dǎo)閾值均明顯降低（P<0.05），且治療組降低更顯著（P<0.05）。結(jié)論 鹽酸洛美沙星滴耳液聯(lián)合頭孢丙烯干混懸劑治療急性化膿性中耳炎患兒可有效改善患兒臨床癥狀，降低骨導(dǎo)閾和機(jī)體炎癥介質(zhì)水平，提高水通道蛋白表達(dá)水平。

Objective To investigate the curative effect of Lomefloxacin Hydrochloride Ear Drops combined with cefprozil in treatment of children with acute suppurative otitis media. Methods The clinical data of 90 children with acute suppurative otitis media treated in Nanyang Central Hospital from March 2020 to March 2021 were analyzed retrospectively, and divided into control and treatment group according to different treatments, and each group had 45 cases. Children in the control group were po administered with Cefprozil for Suspension, once 15 mg/kg, twice daily. Children in the treatment group were administered with Lomefloxacin Hydrochloride Ear Drops on the basis of the control group, 3 drops/time, twice daily, and given an ear bath for about 10 min after ear drops. Children in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the levels of serum CRP, PCT, IL-6, TNF-α, AQP-1 and AQP-4, and bone conduction threshold ratio level in two groups before and after treatment were compared. Results After treatment, the clinical effective rates of the control group and the treatment group were 82.22% and 97.78% respectively (P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of serum CRP, PCT, IL-6 and TNF-α were significantly decreased in two groups (P< 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of serum AQP-1 and AQP-4 were significantly increased in two groups (P < 0.05), especially in the treatment group (P< 0.05). After treatment, the bone conduction threshold of each frequency were significantly decreased in two groups (P < 0.05), and the decrease in the treatment group was more significant (P < 0.05). Conclusion Lomefloxacin Hydrochloride Ear Drops combined with cefprozil in treatment of children with acute suppurative otitis media can effectively improve the clinical symptoms, reduce the bone conduction threshold and the level of inflammatory mediators, and increase the expression level of aquaporins.

R985;R987

河南省醫(yī)學(xué)科技攻關(guān)計劃攻關(guān)項目（2015B2005603）