Objective To investigate the therapeutic effect of dexamethasone on children with severe community acquired pneumonia ( CAP) . Methods 120 children with severe CAP admitted from January 2009 to June 2011 were recruited in the study. The patients were randomly divided into a dexamethasone group ( n = 62) and a control group ( n = 58) . The patients in the dexamethasone group received additional dexamethasone intravenous injection for 3 days ( 0. 2-0. 4 mg· kg- 1 · d- 1 , qd) on the basic treatment of the control group. Length of hospital stay, serum C reactive protein ( CRP) concentration on 4th day after admission, overall efficacy, mortality, incidence of adverse events during treatment were compared between the two groups. Results Median length hospital stay was 8 days in the dexamethasone group compared with 9 days in the control group without significant difference ( P gt;0. 05) . The serumCRP concentration on 4th day was lower in the dexamethasone group than that in the control group [ ( 23. 4 ±5. 6) mmol /L vs. ( 41. 3 ±6. 2) mmol /L, P lt;0. 05] . The overall efficacy was higher in the dexamethasone group than that in the control group ( 88. 7% vs. 74. 1% , P lt; 0. 05) . The in-hospital mortality and incidence of severe adverse events were not significantly different between the two groups ( P gt; 0. 05) . Conclusions Dexamethasone treatment is associated with a significant attenuation in systematic inflammatory response, but does not decrease mortality in hospitalized children with severe CAP.
目的 探討含左氧氟沙星的三聯療法作為一線方案對幽門螺桿菌感染治療的有效性和安全性。 方法 選擇2008年9月－2011年3月125例確診為幽門螺桿菌感染的初治患者，隨機分為雷貝拉唑、阿莫西林聯合左氧氟沙星組（A組）和雷貝拉唑、阿莫西林聯合克拉霉素組（B組），經治療7 d后比較兩組根除率和不良反應發生率。 結果 A、B組幽門螺桿菌符合方案分析根除率分別為91.8%、77.6%，意向性治療根除率分別為88.9%、72.6%，A組根除率高于B組，差異有統計學意義（P＜0.05）。A、B組不良反應發生率分別為4.8%、3.2%（P＞0.05）。 結論 以左氧氟沙星、阿莫西林、雷貝拉唑為組合的三聯療法能顯著提高幽門螺桿菌感染的初治成功率，不良反應少，安全有效。
【摘要】 目的 探討含鉍劑的四聯療法作為一線方案對幽門螺桿菌感染的有效性和安全性。 方法 選擇2008年9月-2010年9月間137例確診幽門螺桿菌感染的初治患者，隨機分為RAC組（雷貝拉唑、阿莫西林和克拉霉素）和RBAC組（雷貝拉唑、阿莫西林、克拉霉素和枸櫞酸鉍鉀）。經治療7 d后比較兩組根除率和不良反應發生率。 結果 RAC組和RBAC組的按方案分析根除率分別為77.6%和90.3%，意向性治療分析根除率分別為72.6%和86.7%。RBAC組的按方案分析和意向性治療分析根除率均高于RAC組（Plt;0.05）。不良反應發生率分別為1.6%和1.3%（Pgt;0.05）。 結論 以雷貝拉唑、阿莫西林、克拉霉素和枸櫞酸鉍鉀為組合的四聯療法能顯著提高幽門螺桿菌感染的初治成功率，不良反應少，安全有效。【Abstract】 Objective To investigate the effectiveness and safety of the quadruple therapy containing a bismuth compound for first-line Helicobacter pylori eradication treatment. Methods A total of 137 patients diagnosed to be Helicobacter pylori-positive between September 2008 and September 2010 were randomized into two groups to receive the combination of rabeprazole, amoxicillin and clarithromycin (RAC group) and the combination of rabeprazole, amoxicillin, clarithromycin and bismuth potassinm citrate (RBAC group) respectively. The efficacy and tolerance were observed after the treatment for 7 days. Results The per protocol (PP) eradication rates of Helicobacter pylori were 86.7% for RAC group and 90.3% for RBAC group (Plt;0.05), respectively. The intention-to-treat protocol (ITT) eradication rates of Helicobacter pylori were 72.6% for RAC group and 86.7% for RBAC group (Plt;0.05), respectively. The was no significant difference in the incidence of side effects between the two groups (1.6% vs. 1.3%, Pgt;0.05). Conclusion The quadruple therapy containing rabeprazole, amoxicillin, clarithromycin and bismuth potassinm citrate provides a good eradication rate of Helicobacter pylori with a good compliance when compared with the standard triple therapy schemes.