The details of the baseline data of the included subjects are summarized in Table 1. Table 1 General information of 2 groups. test, and two-sided 0.05 was used to judge whether there was a statistically significant difference. 3. in the treatment group Mouse monoclonal to MUSK were significantly downregulated compared with those in the control group after treatment. The levels of IgG, IgA, and IgM in the treatment group were not significantly different from those in the control group before treatment but were significantly upregulated after treatment. IL-10, IL-6, and IL-2 levels were also significantly increased in the treatment group. The disappearance time of clinical symptoms such as fever, cough, and pulmonary rales in the treatment group was significantly shorter than that in the control group, and the remedy rate in the treatment group was significantly better than that in the control group. Conclusion The clinical effect of gamma globulin combined with azithromycin sequential therapy in the treatment of children with refractory mycoplasma pneumonia is usually remarkable, which can reduce inflammatory factors, improve patients’ immunity, and promote disease recovery. 1. Introduction Refractory Mycoplasma pneumoniae pneumonia (RMPP) mainly refers to mycoplasma pneumonia characterized by persistent fever, progressive aggravation of clinical symptoms, and related imaging manifestations after 1 week of standard macrolide therapy [1]. Acquired pneumonia with unknown clinical etiology changes rapidly, and extensive pulmonary inflammation can occur in a relatively short period of time, often accompanied by complications such as massive pleural effusion, pleural thickening, lung abscess, and pneumothorax. In more severe cases, children may develop bronchiolitis obliterans, atelectasis, and systemic inflammatory response syndrome, posing serious health risks [2]. At present, the treatment of refractory Mycoplasma pneumoniae pneumonia mainly adopts antibacterial, inhibiting overactive immune response and bronchoalveolar lavage, but the clinical efficacy is still poor [3]. In recent years, azithromycin is usually clinically combined with basic therapy. It has been reported that this pathogenesis of severe Mycoplasma pneumoniae pneumonia is related to cell-mediated immunity, and corticosteroid therapy may be effective. Intravenous immunoglobulin (IVIG) has been used as a potent immunomodulator for Kawasaki disease and other immune-mediated diseases [4]. Intravenous immune globulin can also be used to treat refractory Mycoplasma pneumoniae pneumonia. Therefore, this study is usually aimed at investigating the treatment options for refractory mycoplasma pneumonia in children. 2. Materials and Methods 2.1. Patients From January 2021 to January 2022, 100 pediatric patients diagnosed with refractory mycoplasma pneumonia were randomly divided into 2 groups (50 cases in each). All patients in this study gave informed consent, and the patients themselves or their representatives signed the relevant consent forms. The details of the baseline data of the included subjects are summarized in Table 1. Table 1 General information of 2 groups. test, and two-sided 0.05 was used to judge whether there was a statistically significant difference. 3. Results 3.1. Comparison of Th1, Th2, and Th1/Th2 between the Two Groups before and after Treatment As shown in Table 2, Th1 (0.53 0.15), Th2 (0.47 0.13), and Th1/Th2 (1.41 0.20) in the treatment group were compared with those in the control group Th1 (0.57 0.16), Th2 (0.46 0.14), and Th1/Th2 (1.43 0.15) which had no significant difference (= 2.019, 1.631, and 1.461; = 0.245, 0.131, and 0.102). After treatment, Th1 (0.16 0.14), Th2 (0.18 0.07), and Th1/Th2 (0.39 0.16) in the treatment group were lower than those in the control group Th1 (0.37 0.2), Th2 (0.31 0.06), and Th1/Th2 (0.58 0.58 0.18), and the difference was significant (= 15.943, 12.005, and TFMB-(R)-2-HG 13.325; = 0.001, 0.005, and 0.005). Table 2 Comparison of Th1, Th2, and Th1/Th2 between the two groups of patients. = 1.568, 1.064, and 1.263; = 0.712, 0.070, and 0.065). After treatment, IgG (11.20 1.60), IgA (2.20 0.30), and IgM (1.70 0.10) in the treatment group were significantly higher than those in the control group in terms of IgG (9.50 1.80), IgA (1.80 0.40), and IgM (1.60 0.30, = 12.018, 11.935, and 10.881; = 0.001, 0.003, and 0.001). Table 3 Comparison of serum immunoglobulin levels before and after treatment TFMB-(R)-2-HG between the two groups of TFMB-(R)-2-HG patients. = 12.583, 8.934, and 10.033; = 0.011,.