李华.莫西沙星联合鞘内注射及脑脊液置换治疗有效降低结核性脑膜炎患者脑脊液CK-BB、sCD163及炎症因子[J].内科急危重症杂志,2021,27(3):196-199
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| DOI：10.11768/nkjwzzzz20210305 |
| 中文关键词: 莫西沙星 鞘内注射 脑脊液置换 可溶性CD163 肌酸激酶同工酶BB |
| 英文关键词: |
| 基金项目:保定市科学技术和知识产权局（No：20184123） |
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| 中文摘要: |
| 目的：探讨莫西沙星联合鞘内注射及脑脊液置换治疗对结核性脑膜炎（TBM）患者脑脊液肌酸激酶同工酶BB（CK-BB）、可溶性CD163（sCD163）、炎症因子（TNF-α、IFN-γ）水平的影响及其临床疗效。方法： 选取2015年4月-2019年4月，在河北大学附属医院结核科住院治疗的难治性TBM患者80例，将其按照随机数字表法分为对照组和观察组，各40例。2组患者均行鞘内注射、脑脊液置换治疗及抗结核基础治疗；观察组在此基础上予以莫西沙星静脉滴注治疗。比较2组患者脑脊液中CK-BB、sCD163、肿瘤坏死因子α（TNF-α）、γ干扰素（IFN-γ）含量变化及脑脊液生化指标，并进行疗效判断，观察2组不良反应发生情况。结果：治疗28d后，2组患者脑脊液中CK-BB、sCD163及TNF-α、IFN-γ白细胞、蛋白、脑脊液压力显著降低，且观察组低于对照组（P均＜0.05）；观察组治疗总有效率高于对照组（P＜0.05）。与治疗前比较，2组患者脑脊液中葡萄糖、氯化物水平显著提高，且观察组高于对照组（P均＜0.05），不良反应发生率无明显差异。结论：莫西沙星联合鞘内注射及脑脊液置换治疗能有效降低TBM患者脑脊液CK-BB、sCD163、炎性因子TNF-α、IFN-γ、白细胞及蛋白含量，提高葡萄糖和氯化物水平，且临床疗效较好。 |
| 英文摘要: |
| Objective: To investigate the effects of moxifloxacin combined with intrathecal injection and cerebrospinal fluid replacement on the levels of creatine kinase BB(CK-BB), soluble CD163(sCD163), inflammatory factors (TNF-α, IFN-γ) in cerebrospinal fluid of patients with tuberculous meningitis (TBM) and its clinical efficacy. Methods: A total of 80 cases of refractory TBM hospitalized in the Tuberculosis Department of the Affiliated Hospital of Hebei University from April 2015 to April 2019 were selected and divided into control group and observation group according to random number table method, with 40 cases in each group. Patients in the two groups received intrathecal injection, cerebrospinal fluid replacement therapy and basic anti-tuberculosis therapy. Observation group was given moxifloxacin intravenous infusion additionally. The levels of CK-BB, sCD163, TNF-α and IFN-γ in the cerebrospinal fluid and the biochemical indexes of cerebrospinal fluid were compared between two groups. The efficacy was judged according to relevant standards, and the incidence of adverse reactions in the two groups was observed. Results: After 28 days of treatment, CK-BB, sCD163, TNF-α, IFN-γ, white blood cells, protein and cerebrospinal fluid pressure in two groups were significantly decreased as compared with those before treatment, and those in the observation group were significantly lower than in the control group (all P< 0.05). The total effective rate in the observation group was significantly higher than that in the control group (P< 0.05). As compared with before treatment, the levels of glucose and chloride in cerebrospinal fluid in the two groups were significantly increased, and those in the observation group was significantly higher than in the control group (all P< 0.05). There was no significant difference in the incidence of adverse reactions between two groups. Conclusion: Moxifloxacin combined with intraocular injection and cerebrospinal fluid replacement therapy can effectively reduce the contents of CK-BB, sCD163, inflammatory factors TNF-α, IFN-γ, white blood cells and protein, and increase the levels of glucose and chloride in cerebrospinal fluid, with good clinical efficacy. |
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