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目的 探究联合美罗培南对小儿心衰合并肺炎的治疗效果和肾素活性(PRA)、脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)的影响.方法 筛选2016年4月—2018年4月来青海省妇女儿童医院急诊内科就诊的80例患者资料,随机分为仅给予多巴酚丁胺接受治疗的对照组(n=43)和接受多巴酚丁胺联合美罗培南治疗的观察组(n=37),检测分析治疗前后PRA、BNP和cTnI水平等指标的血清水平.结果 两组治疗后血清PRA、BNP、cTnI、血管紧张素II(AngII)、白介素-6(IL-6)和超敏C反应蛋白(hs-CRP)水平均明显降低(P<0.05),其中观察组降低幅度更明显(P<0.05);两组治疗后AngⅡ、IL-6和hs-CRP水平均明显降低(P<0.05),其中观察组降低幅度更明显(P<0.05);观察组临床治疗有效率明显高于对照组(P<0.05);两组副反应发生率差异不明显(P＞0.05).结论 联合美罗培南治疗小儿心衰合并肺炎的临床效果显著,能有效减低PRA、BNP、cTnI、AngⅡ、IL-6和hs-CRP水平,且不增加用药不良反应.“,”Objective To investigate the effects of meropenem on the clinical effeciency and the effects of renin activity (PRA), brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) on the children with heart failure and pneumonia. Methods The 80 patients who came to our hospital from April 2016 to 2018 were randomly divided into the control group (n=43) treated with dobutamine and the observation group (n=37) treated with dobutamine combined with merope?nem. The serum levels of PRA, BNP, cTnl were measured and analyzed before and after the treatment. Results After treatment, the serum levels of PRA, BNP ,cTnI , angiotensin II(AngII), interleukin-6(IL-6)and high-sensitivity c-reactive protein(hs-CRP)were significantly decreased in the two groups (P<0.05), while the decreasing trend in the ob?servation group was more significant (P<0.05). After treatment, the serum levels of Ang II and IL-6 and hs-CRP were significantly lower (P<0.05), while the decreasing trend in the observation group was more significant(P<0.05). The ef?fective rate of clinical treatment in the observation group was significantly higher than that in the control group (P<0.05). The incidence of side effects in the two groups was not significantly different (P＞0.05). Conclusion The clinical effect is better after the combined meropenem in the treatment of children with heart failure and pneumonia, which can effec?tively reduce the levels of PRA, BNP, cTnI, Ang II, IL-6 and hs-CRP, and does not increase adverse drug reactions.