目的 探讨清开灵注射液联合注射用美罗培南治疗老年重症肺炎的临床疗效。方法 选取2023年2月—2025年10月青岛市第八人民医院收治的82例老年重症肺炎患者，患者按照随机数字表法分为对照组和治疗组，各包括41例。对照组静脉滴注注射用美罗培南，每8小时4支。治疗组在对照组基础上静脉滴注清开灵注射液，4支/d。两组持续治疗10 d。比较两组的临床疗效、肺炎严重程度、症状改善时间、血清指标。结果 治疗组的总有效率为95.12%，对照组的总有效率为80.49%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的肺炎严重指数（PSI）评分均显著降低（P＜0.05），且治疗组PSI评分明显低于对照组（P＜0.05）。治疗组体温复常时间和咳嗽、肺啰音、呼吸困难改善时间均明显短于对照组（P＜0.05）。治疗后，两组的活化蛋白C（APC）显著升高，可溶性髓样细胞触发受体1（sTREM-1）、中性粒细胞与淋巴细胞比值（NLR）显著降低（P＜0.05）；治疗组治疗后的APC明显高于对照组，sTREM-1、NLR明显低于对照组（P＜0.05）。结论 清开灵注射液联合注射用美罗培南可有效提高重症肺炎的疗效，减轻病情严重程度，改善临床症状，降低炎症反应。

Objective To explore the clinical efficacy of Qingkailing Injection combined with Meropenem for injection in treatment of severe pneumonia in elderly. Methods 82 Elderly patients with severe pneumonia admitted to Qingdao Eighth People’s Hospital from February 2023 to October 2025 were selected. The patients were divided into control group and treatment group using a random number table method, 41 cases in each group. The control group received intravenous infusion of Meropenem for injection, with 4 doses every 8 hours. The treatment group received intravenous infusion of Qingkailing Injection on the basis of the control group, with 4 doses daily. The two groups were treated continuously for 10 days. The clinical efficacy, severity of pneumonia, time to symptom improvement, and serum indicators were compared between two groups. Results The total effective rates of the treatment group and the control group were 95.12% and 80.49%, respectively, and the difference between two groups was statistically significant (P < 0.05). After treatment, the PSI scores of two groups were significantly reduced (P < 0.05), and the PSI score of the treatment group was significantly lower than that of the control group (P < 0.05). The recovery time of body temperature and the improvement time of cough, lung rales, and dyspnea in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the levels of APC significantly increased in two groups, while sTREM-1 and NLR significantly decreased (P < 0.05). The APC of the treatment group was significantly higher than that of the control group, while sTREM-1 and NLR were significantly lower than those of the control group (P < 0.05). Conclusion Qingkailing Injection combined with Meropenem for injection can effectively improve the treatment effect of severe pneumonia in elderly, reduce the severity of the disease, improve clinical symptoms, and reduce inflammatory reactions.

R974