目的 探讨阿奇霉素和头孢他啶对难治性肺炎支原体肺炎患儿的临床疗效及血清乳酸脱氢酶（LDH）的变化影响。方法 2014年1月—2017年1月选择在郑州市妇幼保健院诊治的120例难治性肺炎支原体肺炎患儿作为研究对象，根据随机信封抽签原则分为观察组与对照组各60例，观察组在常规治疗基础上给予阿奇霉素辅助治疗，0.25 g/次，1次/d，对照组在常规治疗基础上给予头孢他啶辅助治疗，10～50 mg/kg加入0.5%氯化钠注射液50～100 mL内，静脉泵入，2次/d。两组都治疗14 d。结果 观察组与对照组患儿总有效率分别为98.3%和86.7%，观察组患儿的总有效率显著高于对照组，差异有统计学意义（P<0.05）。观察组与对照组患儿治疗后的血清LDH水平分别为（143.22±26.29）U/L和（245.10±30.91）U/L，都明显低于治疗前的（445.20±35.10）U/L和（438.10±56.11）U/L（P<0.05）；且治疗后观察组患儿的血清LDH水平也明显低于对照组，差异有统计学意义（P<0.05）。观察组患儿治疗期间的皮疹、胃肠道反应、疼痛、发热等不良反应发生率为11.7%，对照组为10.0%，两组对比无明显差异。结论 相对于头孢他啶，阿奇霉素治疗难治性肺炎支原体肺炎患儿能提高治疗效果，且不会增加不良反应，其作用机制可能与促进血清LDH含量降低有关。

Objective To investigate the effect of azithromycin and ceftazidime on serum lactate dehydrogenase (LDH) in children with refractory mycoplasma pneumoniae pneumonia.Methods From January 2014 to January 2017, 120 children with refractory mycoplasma pneumoniae pneumonia in Women and Infants Hospital of Zhengzhou were selected as research object, all the cases were equally divided into observation group and control group with 60 cases in each group according to the random draw envelope principle, the observation group was given azithromycin adjuvant treatment, the control group was given cephalosporin adjuvant therapy, two groups were treated for 14 d.Results The total effective rates of observation group and control group were 98.3% and 86.7%, respectively, the total effective rate of observation group was significantly higher than that of control group, the difference was statistically significant (P<0.05). The serum levels of LDH in observation group and control group after treatment were (143.22±26.29) and (245.10 ±30.91) U/L that were significantly lower than those before treatment of (445.20 ±35.10) and (438.10 ±56.11) U/L (P<0.05), and the serum level of LDH in observation group after treatment was significantly lower than that of the control group (P<0.05). The incidence of adverse reactions such as rash, gastrointestinal reaction, pain, fever and other adverse reactions in the observation group was 11.7%, which was 10.0% in the control group. Comparison between the two groups had not significant difference (P<0.05).Conclusion Compared with cephalosporins, azithromycin in the treatment of refractory mycoplasma pneumoniae pneumonia in children can improve the therapeutic effect, and does not increase the incidence of adverse reactions, the mechanism may be related to the decrease of the content of serum LDH.