不同抗菌药物治疗癫痫合并院内细菌性感染的效果

Effects of different antibiotics on epilepsy complicated with nosocomial bacterial infections

目的探讨不同抗菌药物治疗癫痫合并院内细菌性感染的效果。方法选取2017年1月至2018年9月我院收治的100例癫痫合并院内细菌性感染患者进行前瞻性研究,采用随机数字表法将其分为头孢噻肟组与阿奇霉素组,各50例。两组均给予规律抗癫痫药物治疗,在此基础上头孢噻肟组给予头孢噻肟,阿奇霉素组给予阿奇霉素。比较两组患者的丙戊酸钠血药浓度、癫痫发作次数、单次癫痫持续时间、抗感染效果、血清炎症因子水平及不良反应发生率。结果抗菌药物给药前,两组患者丙戊酸钠血药浓度无显著差异(P>0.05)。抗菌药物给药7d后,两组患者丙戊酸钠血药浓度均低于给药前(P<0.05);阿奇霉素组丙戊酸钠血药浓度高于头孢噻肟组(P<0.05)。阿奇霉素组的癫痫发作次数少于头孢噻肟组,单次癫痫持续时间短于头孢噻肟组(P<0.05)。阿奇霉素组的抗感染治疗总有效率高于头孢噻肟组(P<0.05)。阿奇霉素组的CRP、IL-6、TNF-α、PCT水平均低于头孢噻肟组(P<0.05)。两组患者恶心呕吐、腹胀、皮疹及乏力发生率比较,差异无统计学意义(P>0.05)。结论阿奇霉素对癫痫合并院内细菌性感染患者具有良好的抗炎作用,且其对丙戊酸钠血药浓度的影响较轻微,有利于保证患者的抗癫痫治疗效果。

Objective To explore the effects of different antibiotics on epilepsy complicated with nosocomial bacterial infections. Methods From January 2017 to September 2018, a total of 100 epilepsy patients with nosocomial bacterial infections were selected for prospective study. The patients were divided into cefotaxime group and azithromycin group according to random number table method, with 50 cases in each group. Both groups were given regular antiepileptic drugs. On this basis, the cefotaxime group was given cefotaxime, and the azithromycin group was given azithromycin. The blood concentration of sodium valproate, the frequency of epileptic seizures, the duration of single epilepsy, the anti-infective effect, the level of serum inflammatory factors and the incidence of adverse reactions were compared between the two groups. Results There was no significant difference in blood concentration of sodium valproate between the two groups before administration of antibiotics (P>0.05). Seven days after administration of antibiotics, the blood concentration of sodium valproate in both groups was lower than that before administration (P<0.05);the blood concentration of sodium valproate in the azithromycin group was higher than that of the cefotaxime group (P<0.05). The frequency of epileptic seizures in the azithromycin group was less than that of the cefotaxime group, and the duration of single epilepsy was shorter than that of the cefotaxime group (P<0.05). The total effective rate of anti-infection in the azithromycin group was higher than that of the cefotaxime group (P<0.05). The levels of CRP, IL-6, TNF-α and PCT in the azithromycin group were lower than those of the cefotaxime group (P<0.05). There were no significant differences in the incidences of nausea, vomiting, abdominal distension, rash and fatigue between the two groups (P>0.05). Conclusion Azithromycin has a good anti-inflammatory effect on epilepsy patients with nosocomial bacterial infections, and it has a slight inflnence on the blood concentration of sodium valproate, which is conducive to ensuring the antiepileptic effect of patients.