摘要
目的探讨替加环素(TGC)联合药物治疗泛耐药鲍曼不动杆菌(PDR-Ab)中枢神经系统感染的效果。方法选取2017-02—2020-02驻马店市第一人民医院收治的108例PDR-Ab中枢神经系统感染患者为研究对象,根据随机数表法分为TGC-头孢哌酮/舒巴坦(CPZ/SB)组(TGC-CPZ/SB组)和TGC-异帕米星(ISM)组(TGC-ISM组),比较2组患者入院后24 h内及治疗10 d炎性指标、急性生理功能与慢性健康状况Ⅱ(APACHEⅡ)评分、细菌清除率、不良反应发生情况及临床总有效率。结果治疗10 d后TGC-CPZ/SB组和TGC-ISM组白细胞数(14.33±2.16 vs 12.59±3.10)、C反应蛋白(75.85±16.27 vs 63.16±15.33)、脂多糖(15.58±4.23 vs 12.11±2.34)、降钙素原(2.26±0.77 vs 1.43±0.57)、白细胞介素-6(39.84±5.25 vs 31.42±4.29)比较差异有统计学意义(P<0.05),且均显著低于治疗前(P<0.05);治疗10 d后TGC-ISM组APACHEⅡ评分(11.57±3.28)分,显著低于TGC-CPZ/SB组的(13.66±4.25)分(P<0.05);TGC-ISM组细菌清除率(74.07%)显著高于TGC-CPZ/SB组(55.56%)(P<0.05);2组恶心呕吐、听力减退、头痛、关节痛、视力模糊等不良反应发生率比较差异无统计学意义(P>0.05);TGC-ISM组临床总有效率88.89%,显著高于TGC-CPZ/SB组的70.37%,差异有统计学意义(P<0.05)。结论TGC联合ISM方案治疗PDR-Ab中枢神经系统感染的临床疗效良好,抑炎效果更好,且安全性高。
Objective To explore the effect of tigecycline(TGC)combined with drugs in the treatment of pan-resistant Acinetobacter baumannii(PDR-Ab)infections of the central nervous system.Methods A total of 108 PDR-Ab patients with central nervous system infection admitted to the First People’s Hospital of Zhumadian from February 2017 to February 2020 were selected as the research objects,and they were divided into TGC-Cefoperazone/Sulbactam(CPZ/SB)group(TGC-CPZ/SB group)and TGC-Iepamicin(ISM)group(TGC-ISM group),compare the inflammatory indexes,acute physiological function and the relationship between the two groups within 24 hours after admission and 10 days after treatment chronic health statusⅡ(APACHEⅡ)score,bacterial clearance rate,occurrence of adverse reactions and total clinical effective rate.Results After 10 days of treatment,the number of white blood cells(14.33±2.16 vs 12.59±3.10),C-reactive protein(75.85±16.27 vs 63.16±15.33),lipopolysaccharide(15.58±4.23 vs 12.11±2.347)in the TGC-CPZ/SB group and TGC-ISM group,procalcitonin(2.26±0.77 vs 1.43±0.57),interleukin-6(39.84±5.25 vs 31.42±4.29),the difference was statistically significant(P<0.05),and they were significantly lower than before treatment(P<0.05);APACHEⅡscore(11.57±3.28)in TGC-ISM group after 10 days of treatment,which was significantly lower than(13.66±4.25)in TGC-CPZ/SB group(P<0.05);Bacteria in TGC-ISM group The clearance rate(74.07%)was significantly higher than that in the TGC-CPZ/SB group(55.56%)(P<0.05);there was no significant difference in the incidence of adverse reactions such as nausea and vomiting,hearing loss,headache,joint pain,and blurred vision in the two groups significance(P>0.05);the total clinical effective rate of the TGC-ISM group was 88.89%,which was significantly higher than the 70.37%of the TGC-CPZ/SB group,and the difference was statistically significant(P<0.05).Conclusion TGC combined with ISM regimen has better clinical efficacy,better anti-inflamm.
作者
贾建成
孙东辉
夏冬雪
王彦彬
JIA Jiancheng;SUN Donghui;XIA Dongxue;WANG Yanbin(The First People’s Hospital of Zhumadian,Zhumadian 463000,China)
出处
《中国实用神经疾病杂志》
2021年第4期323-328,共6页
Chinese Journal of Practical Nervous Diseases
基金
2019年河南省医学科技攻关计划共建项目(编号:LHGJ20191455)。
关键词
替加环素
泛耐药
鲍曼不动杆菌
中枢神经系统感染
Tigecycline(TGC)
Pan-drug resistant(PDR)
Acinetobacter baumannii(Ab)
Central nervous system infection
