目的 观察长期低剂量服用克拉霉素治疗不同阶段非囊性纤维化支气管扩张的临床效果。方法 选择处于不同阶段的支气管扩张患者50例， 按病情轻重分成两组， 均口服克拉霉素0.25 g， 1/d， 4个月， 进行前瞻性研究， 对比观察研究起点以及终点时两组患者在痰液量、气促指数以及肺功能相关指标方面的改变， 并统计在治疗期间因急性加重而住院患者的住院时间及住院费用与以往住院时的差异。结果 两组患者治疗后痰液量均显著减少( P<0.01)， 轻症患者治疗后的气促指数、肺功能指标FVC、FEV1及PEF均有改善( P<0.05)， 但重症患者除PEF外其他改善均不明显。此外， 两组中因急性加重而住院的患者， 住院时间及住院费用较以往有明显减少( P<0.05)。结论 长期低剂量克拉霉素治疗对于减少支气管扩张患者的痰液量、改善轻症患者肺功能相关指标有明显益处， 住院患者联合应用该药物可减少住院时间及住院费用。

Objective To study the clinical effects of long-term low-dose clarithromycin on non-cystic bronchiectasis patients at different stages. Methods A total of 50 bronchiectasis patients at different stages were recruited, divided into two groups by severity, and each group were given oral clarithromycin of 0.25 qd for 4 months. The differences between the two groups of patients at the starting point and end point in sputum volume, dyspnea index, lung function related indicators as well as the hospital stay and hospital costs for acute exacerbation were compared. Results Sputum volume significantly reduced ( P<0.01) in the two groups of patients after treatment. Dyspnea index and indicators of lung function in relatively mild condition patients with FVC, FEV1 and PEF were improved ( P<0.05), however, critically ill patients had little improvement in addition to PEF. The time of hospitalization and hospital costs because of acute exacerbation in the two groups of patients were significantly reduced ( P<0.05) , compared with than in the past. Conclusions The treatment of long-term low-dose clarithromycin has significant benefits in reducing the amount of sputum in patients with bronchiectasis, and can improve lung function in patients with mild indicators. Joint use of the drug can reduce the length of stay and hospital costs to hospitalized patients.