目的 探討鹽酸洛美沙星滴耳液聯(lián)合阿莫西林顆粒治療兒童急性中耳炎的療效及對血清炎癥介質(zhì)水平的影響。方法 回顧性分析2020年2月—2021年2月在天津醫(yī)科大學(xué)總醫(yī)院進(jìn)行治療的104例急性中耳炎患兒的臨床資料，根據(jù)用藥差別分為對照組和治療組，每組各52例。對照組口服阿莫西林顆粒，每日劑量按體質(zhì)量20～40 mg/kg，分3次口服；治療組在對照組治療基礎(chǔ)上給予鹽酸洛美沙星滴耳液，3滴/次，2次/d，點(diǎn)耳后進(jìn)行約10 min耳浴。兩組治療10 d進(jìn)行效果比較。觀察兩組的臨床療效，比較兩組臨床癥狀改善時間、血清炎癥介質(zhì)水平、miR-203a和miR-155水平。結(jié)果 治療后，治療組總有效率98.08%，顯著高于對照組的82.69%（P<0.05）。經(jīng)治療，治療組耳痛、耳悶、耳鳴、流膿等癥狀改善時間短于對照組（P<0.05）。經(jīng)治療，兩組血清C反應(yīng)蛋白（CRP）、降鈣素原（PCT）、白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）水平均較治療前顯著下降（P<0.05）；且治療后，治療組炎癥介質(zhì)水平低于對照組（P<0.05）。經(jīng)治療，兩組血清miR-203a和miR-155水平均顯著下降（P<0.05）；且治療后，治療組miR-203a和miR-155水平低于對照組（P<0.05）。結(jié)論 鹽酸洛美沙星滴耳液聯(lián)合阿莫西林顆粒治療兒童急性中耳炎具有較好的臨床療效，可有效改善患兒臨床癥狀，降低機(jī)體炎癥介質(zhì)水平，有著良好的臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Lomefloxacin Hydrochloride Ear Drops combined with amoxicillin in treatment of children with acute otitis media and its effect on serum inflammatory mediators. Methods Clinical data of 104 children with acute otitis media who were treated in Tianjin Medical University General Hospital from February 2020 to February 2021 were retrospectively analyzed, and divided into control group and treatment group according to medication difference, with 52 cases in each group. Patients in the control group were po administered with Amoxicillin Granules in three times, 20 — 40 mg/kg. Patients in the treatment group were given Lomefloxacin Hydrochloride Ear Drops on the basis of the control group, 3 drops/time, twice daily, ear bath for about 10 min after ear tip. The effects of the two groups were compared after 10 days of treatment. The clinical efficacy of the two groups was observed, and the clinical symptom improvement time, serum inflammatory mediator level, miR-203a and miR-155 levels were compared between two groups. Results After treatment, the total effective rate of the treatment group was 98.08%, which was significantly higher than that of the control group (82.69%, P < 0.05). After treatment, the improvement time of symptoms such as earache, tightness, tinnitus, and purulent discharge in treatment group was shorter than that in control group (P < 0.05). After treatment, the levels of serum C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of inflammatory mediators in treatment group was lower than that in control group (P < 0.05). After treatment, the serum miR-203a and miR-155 levels in both groups were significantly decreased (P < 0.05). After treatment, miR-203a and miR-155 levels in the treatment group were lower than those in the control group (P < 0.05). Conclusion Lomefloxacin Hydrochloride Ear Drops combined with amoxicillin has good clinical effect in treatment of children with acute otitis media, and can effectively improve the clinical symptoms of children, reduce the level of inflammatory mediators in the body, which has good clinical application value.

R987

天津市科技計(jì)劃項(xiàng)目（17JCPJB46710）