摘要
目的探讨注射用甲泼尼龙琥珀酸钠冲击联合更昔洛韦治疗重症病毒性脑膜炎的应用价值。方法选取山西省煤炭中心医院2016年1月至2018年2月收治的重症病毒性脑膜炎患者98例,按照随机数字表法分为观察组与对照组,每组49例。在常规治疗基础上,对照组给予更昔洛韦+地塞米松治疗,观察组给予更昔洛韦+注射用甲泼尼龙琥珀酸钠冲击治疗。比较两组临床疗效、症状及体征改善情况、治疗前后血清炎性因子[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平及功能评分[神经功能(NIHSS评分)、运动功能(Fugl-Meyer积分)、生活活动能力(ADL评分)]变化,统计比较两组治疗期间不良反应发生率。结果①临床疗效:观察组治疗总有效率[91.84%(45/49)]高于对照组[75.51%(37/49),P<0.05];②症状、体征改善情况:观察组抽搐、发热、颈项强直、精神症状改善时间短于对照组(P<0.05);③血清炎性因子水平:治疗后两组血清PCT、TNF-α、IL-6、IL-8水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);④功能评价:治疗后两组NIHSS评分、Fugl-Meyer积分、ADL评分较治疗前改善(P<0.05),且观察组NIHSS评分低于对照组,Fugl-Meyer积分、ADL评分高于对照组(P<0.05);⑤安全性:两组治疗期间白细胞减少、血小板减少、皮疹、头晕、恶心/呕吐等不良反应发生率比较差异未见统计学意义(P>0.05)。结论重症病毒性脑膜炎患者给予注射用甲泼尼龙琥珀酸钠冲击联合更昔洛韦治疗,效果显著,有利于患者临床症状、体征缓解,降低机体炎症反应程度,改善患者功能状态,且具有一定安全性。
Objective To investigate the value of methylprednisolone sodium succinate for injection combined with ganciclovir in the treatment of severe viral meningitis. Methods Ninety-eight patients with severe viral meningitis from January 2016 to February 2018 were enrolled in Shanxi Coal Central Hospital. The patients were divided into observation group and control group according to the random number table method, with 49 cases in each group. On the basis of routine treatment, the control group was treated with ganciclovir + dexamethasone, while the observation group was treated with ganciclovir + methylprednisolone sodium succinate for injection. The clinical efficacy, symptoms and signs, serum inflammatory factors [procalcitonin (PCT), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-8 (IL-8)] levels and functional scores [neurological function (NIHSS score), motor function (Fugl-Meyer score), activity of life (ADL score) changes before and after treatment were compared between the two groups. The incidences of adverse reactions during treatment were compared between the two groups. Results ①Clinical efficacy: the total effective rate of observation group was 91.84%(45/49), which was higher than that of control group [75.51%(37/49), P<0.05].②Improvement of symptoms and signs: the improvement time of convulsions, fever, neck stiffness and mental symptoms in the observation group was shorter than that in the control group (P<0.05);③Serum inflammatory factor levels: the levels of serum PCT, TNF-α, IL-6 and IL-8 in the two groups were lower than those before treatment (P<0.05), and the levels in the observation group was lower than those in the control group (P<0.05);④Functional evaluation: after treatment, the NIHSS score, Fugl-Meyer score and ADL score in the two groups were improved compared with those before treatment (P<0.05), and the NIHSS score in the observation group was lower than that in the control group, while the Fugl-Meyer score and ADL score in the observation group were
作者
王晓娇
Wang Xiaojiao(Shanxi Coal Central Hospital, Taiyuan 030006, China)
出处
《中国实用医刊》
2019年第6期101-105,共5页
Chinese Journal of Practical Medicine
关键词
重症病毒性脑膜炎
更昔洛韦
注射用甲泼尼龙琥珀酸钠
炎性因子
神经功能
Severe viral meningitis
Ganciclovir
Methylprednisolone sodium succinate for injection
Inflammatory factors
Neurological function
