摘要
目的研究替加环素联合美罗培南治疗鲍氏不动杆菌颅内感染的临床效果。方法选取2017年11月-2020年11月西南医科大学附属医院神经外科术后鲍氏不动杆菌颅内感染患者148例,按照治疗方式的不同分为替加环素组和联合组,各74例。替加环素组使用替加环素静脉注射,联合组在替加环素组的基础上给予脑室注射美罗培南,两组患者共治疗3周。于治疗前、治疗1周后、治疗3周后检测免疫功能相关指标[免疫球蛋白A、G(IgA、IgG)、T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+))]、氧化应激相关指标[丙二醛(MDA)、总抗氧化能力(TAC)、超氧化物歧化酶(SOD)]、脑脊液相关指标(白细胞、蛋白质水平),统计术后卧床时间、体征稳定时间、术后住院时间及治疗效果。结果与治疗前相比,两组患者治疗1周后、3周后IgA、IgG、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、TAC、SOD水平升高,MDA、白细胞计数、蛋白质水平降低;与替加环素组治疗1周后、3周后相比,联合组治疗1周后、3周后IgA、IgG、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、TAC、SOD水平均升高,MDA、白细胞计数、蛋白质水平均降低(P<0.05)。与替加环素组相比,联合组治疗3周后总有效率升高,术后卧床时间,体征稳定时间、术后住院时间均减少(P<0.05)。结论替加环素联合美罗培南改善鲍氏不动杆菌颅内感染患者免疫功能、氧化应激反应,临床疗效较好。
OBJECTIVE To observe the clinical effect of tigecyline combined with meropenem on treatment of Acinetobacter baumannii intracranial infection.METHODS From Nov 2017 to Nov 2020,a total of 148 patients who had A.baumannii intracranial infection after neurosurgery were enrolled in the study and were divided into the tigecycline group and the combination group according to the treatment method,with 74 cases in each group.The tigecycline group was treated with intravenous injection of tigecycline,and the combination group was given ventricular injection of meropenem on basis of the treatment of the tigecycline group.Both groups were treated for 3 weeks.The levels of immune function indexes immunoglobulin A,G(Ig A,Ig G),T lymphocytes(CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)),oxidative stress indexes malondialdehyde(MDA),total antioxidant capacity(TAC),superoxide dismutase(SOD)and cerebrospinal fluid indexes(white blood cells,protein)were detected before the treatment and after the treatment for 1 and 3 weeks.The postoperative bedridden time,time of stable sign,postoperative length of hospital stay and therapeutic effects were statistically analyzed.RESULTS The levels of IgA,IgG,CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),TAC and SOD of the two groups of patients were higher after the treatment for 1 and 3 weeks than before the treatment,while the levels of MDA,WBC and proteins were lower after the treatment for 1 and 3 weeks than before the treatment.The levels of IgA,IgG,CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),TAC and SOD of the combination group were significantly higher than those of the tigecycline group after the treatment for 1 and 3 weeks,while the levels of MDA,WBC and proteins of the combination group were significantly lower than those of the tigecycline group(P<0.05).The total effective rate of the combination group was significantly higher than that of the tigecycline group after the treatment for 3 weeks;the positive bedridden time,time of stable signs and postoperative length of hospital stay were significantly shorter in the combination group than in the tigecycline group(P<0.05).CONCLUSION Tigecycline combined with meropenem may improve the immune function and oxidative stress response of the patients with A.baumannii intracranial infection,with the clinical effect remarkable.
作者
冯玉
冯莉
吴泽秀
杨茜
黄荣惠
FENG Yu;FENG Li;WU Ze-xiu;YANG Qian;HUANG Rong-hui(School of Nursing,Chengdu Medical College,Chengdu,Sichuan 610083,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第22期3407-3411,共5页
Chinese Journal of Nosocomiology
基金
四川省教育厅基金资助项目(17SB0110)。
关键词
替加环素
美罗培南
鲍氏不动杆菌
颅内感染
免疫功能
氧化应激
Tigecycline
Meropenem
Acinetobacter baumannii
Intracranial infection
Immune function
Oxidative stress
