脑脊液置换联合鞘内注射治疗结核性脑膜炎的疗效及对患者脑脊液白介素8与干扰素γ水平的影响

Effect of cerebrospinal fluid replacement combined with intrathecal injection on tuberculous meningitis and the levels of interleukin-8 and interferon-gamma in cerebrospinal fluid

目的探讨脑脊液置换联合鞘内注射治疗结核性脑膜炎的疗效及对患者脑脊液白介素8、干扰素γ水平的影响.方法选取本院2015年1月至2017年1月收治的94例结核性脑膜炎患者作为观察对象,按照治疗方法分为两组,各47例.对照组给予常规治疗,研究组在此基础上给予脑脊液置换联合鞘内注射液治疗,对比两组疗效、临床症状消失时间及白介素8、干扰素γ水平.结果研究组治疗总有效率93.62%,高于对照组78.72%,差异有统计学意义(P<0.05);研究组头痛、体温升高、脑脊液压力升高、脑膜刺激征症状消失时间分别为(16.73±3.85)d、(13.65±3.07)d、(20.14±3.25)d、(21.86±3.77)d,均短于对照组,差异均有统计学意义(均P<0.05);治疗后,两组脑脊液白介素-8、干扰素γ水平均降低,研究组脑脊液白介素-8、干扰素γ水平分别为(1 425.53±103.12) ng/L、(25.11±8.76) ng/L,均低于对照组,差异均有统计学意义(均P<0.05).结论脑脊液置换联合鞘内注射治疗可提高结核性脑膜炎治疗效果,利于改善患者临床症状及脑脊液白介素8、干扰素γ水平.

Objective To investigate the effect of cerebrospinal fluid replacement combined with intrathecal injection on tuberculous meningitis and the levels of interleukin-8 and interferon-gamma in cerebrospinal fluid.Methods 94 patients with tuberculous meningitis admitted to our hospital from January,2015 to January,2017 were selected as observation objects.According to the treatment methods,they were divided into a control group and a research group.The control group was given routine treatment.On this basis,the research group was given cerebrospinal fluid replacement and intrathecal injection.The curative effect,the times for the disappearance of clinical symptoms and the levels of interleukin-8 and interferon-gamma were compared between the two groups.Results The total effective rate was higher in the research group than in the control group (93.62% vs.78.72%,P < 0.05).The times for the disappearance of headache,body temperature increase,cerebrospinal fluid pressure increase,and meningeal irritation were (16.73±3.85) d,(13.65±3.07) d,(20.14±3.25) d,and (21.86±3.77) d in the research group,which were shorter than those in the control group (all P < 0.05).After the treatment,the levels of interleukin-8 and interferon-gamma in the cerebrospinal fluid decreased in the two groups,and were (1 425.53±103.12) ng/L and (25.11±8.76) ng/L in the research group,which lower than those in the control group (P < 0.05).Conclusion Cerebrospinal fluid replacement combined with intrathecal injection for tuberculous meningitis can improve the therapeutic effect and the patients' clinical symptoms and levels of interleukin-8 and interferon-gamma in cerebrospinal fluid.