摘要
目的:探讨替加环素(静脉联合脑室给药)联合胸腺法新治疗鲍曼不动杆菌(Ab)颅内感染的临床效果。方法:选取2021年6月至2023年6月该院收治的Ab颅内感染患者64例,采用随机数字表法分为观察组、对照组,各32例。对照组患者给予替加环素静脉联合脑室给药治疗,观察组患者在对照组的基础上加用胸腺法新。比较两组患者治疗3周后的疗效,治疗前、治疗1周后和治疗3周后的格拉斯哥昏迷评分(GCS)、序贯器官衰竭评分(SOFA)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、脑脊液指标(蛋白质、白细胞计数)、血清炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)]及免疫功能指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、免疫球蛋白(Ig)A和IgG]水平。结果:治疗1、3周后,观察组患者GCS评分高于对照组,SOFA评分、APACHEⅡ评分低于对照组,差异均有统计学意义(P<0.05)。治疗1、3周后,观察组患者脑脊液蛋白质水平、白细胞计数低于对照组,差异均有统计学意义(P<0.05)。治疗1、3周后,观察组患者血清IL-6、TNF-α和CRP水平低于对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IgA和IgG水平高于对照组,差异均有统计学意义(P<0.05)。观察组患者的总有效率为96.88%(31/32),较对照组的75.00%(24/32)更高,差异有统计学意义(P<0.05)。结论:替加环素(静脉联合脑室给药)联合胸腺法新治疗Ab颅内感染患者,可改善炎症反应与免疫功能,促进病情好转,提高临床疗效。
OBJECTIVE:To probe into the clinical effects of tigecycline(intravenous combined with intraventricular administration)combined with thymalfasin in the treatment of Acinetobacter baumannii(Ab)intracranial infection.METHODS:A total of 64 patients with Ab intracranial infection admitted into the hospital from Jun.2021 to Jun.2023 were selected to be divided into observation group and control group via random number table method,with 32 cases in each group.The control group was given tigecycline intravenous combined with intraventricular administration,while the observation group received thymalfasin based on the control group.The efficacy after 3 weeks of treatment,the Glasgow coma scores(GCS),sequential organ failure scores(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,cerebrospinal fluid indicators(protein,white blood cell count),serum inflammatory factor[interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and C-reactive protein(CRP)]levels and immune function indicators[CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin(Ig)A,IgG]were measured before treatment,and after treatment of 1 and 3 weeks.RESULTS:After treatment of 1 and 3 weeks,the GCS scores were higher,the SOFA scores and APACHEⅡscores were lower in the observation group than those in the control group,with statistically significant differences(P<0.05).After treatment of 1 and 3 weeks,the cerebrospinal fluid protein levels and white blood cell counts of the observation group were lower than those of the control group,with statistically significant differences(P<0.05).After treatment of 1 and 3 weeks,the serum IL-6,TNF-αand CRP levels were lower,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+),IgA and IgG levels were higher in the observation group than those in the control group,with statistically significant differences(P<0.05).The total effective rate of the observation group was 96.88%(31/32),higher than 75.00%(24/32)of the control group,with statistically significant difference(P<0.05).CONCLUSIONS:The combination of tigecycline(intravenous combined with intraventricular administration)and thymalfasin in the treatment of patients with Ab intracranial infection can improve inflammatory reaction and immune function,promote disease condition and enhance clinical efficacy.
作者
梁悦
吕娜
朱秀林
LIANG Yue;LYU Na;ZHU Xiulin(Clinical Pharmacy and Trial Center,the First People’s Hospital of Jinzhong,Shanxi Jinzhong 030600,China;Dept.of Rehabilitation Medicine,the First People’s Hospital,Shanxi Jinzhong 030600,China)
出处
《中国医院用药评价与分析》
2024年第12期1454-1457,1461,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
山西省中医药管理局科研课题(No.2020ZYYC051)。
关键词
替加环素
胸腺法新
脑室给药
鲍曼不动杆菌
颅内感染
Tigecycline
Thymalfasin
Intraventricular administration
Acinetobacter baumannii
Intracranial infection
