摘要
目的观察复方磺胺甲[口恶]唑与头孢曲松对合并发热的神经型布氏杆菌病患者疗效及脑脊液炎性因子水平影响的比较。方法选取2021年8月—2023年12月新疆医科大学第一附属医院感染科诊治合并发热的神经型布氏杆菌病患者88例作为研究对象,随机数字表法分为对照组(n=44)和观察组(n=44)。2组患者均接受利福平、多西环素治疗,对照组加用头孢曲松钠,观察组加用复方磺胺甲[口恶]唑,患者均连续治疗6周。治疗前后比较2组异常症状、体征、血常规及生化指标、脑脊液炎性因子的变化;治疗6周后比较2组患者治疗有效率及不良事件发生率。结果观察组患者治疗总有效率高于对照组(97.73%vs.84.09%,χ^(2)/P=4.950/0.026);治疗6周后,2组患者红细胞沉降率(ESR)、血清C反应蛋白(CRP)及降钙素原(PCT)水平均低于治疗前,且观察组均低于对照组(t/P=5.342/<0.001、5.654/<0.001、5.543/<0.001);2组患者脑脊液白介素10(IL-10)、肿瘤坏死因子α(TNF-α)及干扰素γ(IFN-γ)水平均低于治疗前,且观察组均低于对照组(t/P=4.273/<0.001、3.140/0.002、2.650/0.010);2组患者异常症状及体征、不良反应总发生率比较差异无统计学意义(P>0.05)。结论包含复方磺胺甲[口恶]唑的三联药物治疗方案能够有效改善合并发热的神经型布氏杆菌病患者异常症状及体征,明显降低患者脑脊液炎性因子水平,提高整体临床治疗效果,且不良反应发生率较低。
Objective To explore the impact of ceftriaxone and compound sulfamethoxazole on the therapeutic outcomes and levels of inflammatory markers in the cerebrospinal fluid of patients suffering from neuroborreliosis accompanied by fever.Methods From August 2021 to December 2023,88 patients diagnosed with neuroborreliosis were admitted to our hospital and divided randomly into two groups:the standard treatment group(n=44)and the combined treatment group(n=44).Both groups received a treatment regimen consisting of rifampicin and doxycycline.Additionally,ceftriaxone sodium was administered to the standard treatment group,while the combined treatment group received compound sulfamethoxazole.Treatment was carried out continuously for a duration of 6 weeks.A comparative analysis was conducted on the demographic characteristics of the patients in the two groups,changes in abnormal symptoms and signs,as well as variations in blood routine and biochemical indexes and cerebrospinal fluid inflammatory markers before and after treatment.Furthermore,the study also assessed the treatment response rates and the occurrence of adverse events in both groups.Results The overall treatment efficacy in the combined therapy group reached 97.73%,surpassing significantly the efficacy observed in the standard treatment group(84.09%,χ2/P=4.950/0.026).Post-treatment,the mean values of erythrocyte sedimentation rate(ESR),serum C reactive protein(CRP),and procalcitonin(PCT)in the combined therapy group exhibited a significant decline compared to baseline levels and standard treatment group(t/P=5.342/<0.001,5.654/<0.001,5.543/<0.001).Furthermore,the average concentrations of interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and interferon gamma(IFN-γ)in the cerebrospinal fluid of the combined therapy group were markedly lower post-treatment than those in the pre-treatment and standard treatment groups(t/P=4.273/<0.001,3.140/0.002,2.650/0.010).Moreover,there was no discernible difference in the total incidence of adverse reactions between the
作者
刘波
孙晓风
郑丽娇
陈慧园
石雪梅
Liu Bo;Sun Xiaofeng;Zheng Lijiao;Chen Huiyuan;Shi Xuemei(State Key Laboratory for the Cause and Control of High Incidence in Central Asia,Jointly Established by the Ministry and the Province,Xinjiang Province,Urumqi 841100,China;不详)
出处
《疑难病杂志》
CAS
2024年第9期1070-1074,共5页
Chinese Journal of Difficult and Complicated Cases
基金
省部共建中亚高发病成因与防治国家重点实验室资助项目(SKL-HIDCA-2023-38)。
