目的 探讨盐酸洛美沙星滴耳液联合头孢丙烯干混悬剂治疗急性化脓性中耳炎患儿的临床疗效。方法 回顾性分析2020年3月—2021年3月在南阳市中心医院治疗的90例急性化脓性中耳炎患儿的临床资料，根据用药的差别分为对照组和治疗组，每组各45例。对照组口服头孢丙烯干混悬剂，每次15 mg/kg，2次/d；治疗组在对照组基础上给予盐酸洛美沙星滴耳液，3滴/次，2次/d，滴耳后进行约10 min耳浴。两组均经14 d治疗。观察两组患者临床疗效，比较治疗前后两组临床症状改善时间，血清C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、水通道蛋白-1（AQP-1）和水通道蛋白-4（AQP-4）水平，及骨导阈值。结果 治疗后，对照组和治疗组临床有效率分别为82.22%和97.78%，两组比较差异有统计学意义（P<0.05）。经治疗，治疗组临床症状改善时间均明显早于对照组（P<0.05）。经治疗，两组血清CRP、PCT、IL-6、TNF-α水平均明显下降（P<0.05），且治疗组降低更显著（P<0.05）。经治疗，两组血清AQP-1、AQP-4均明显增高，且治疗组升高更明显（P<0.05）。经治疗，两组各频率骨导阈值均明显降低（P<0.05），且治疗组降低更显著（P<0.05）。结论 盐酸洛美沙星滴耳液联合头孢丙烯干混悬剂治疗急性化脓性中耳炎患儿可有效改善患儿临床症状，降低骨导阈和机体炎症介质水平，提高水通道蛋白表达水平。

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

河南省医学科技攻关计划攻关项目（2015B2005603）