甲硝唑联合头孢曲松、多西环素治疗盆腔炎的临床疗效

Clinical effects of metronidazole combined with ceftriaxone and doxycycline in treatment of pelvic inflammatory disease

目的分析甲硝唑联合头孢曲松、多西环素治疗盆腔炎的临床疗效及对细胞因子、免疫功能和血液流变学的影响。方法将95例盆腔炎患者随机分为对照组(n=50)和试验组(n=45),对照组予头孢曲松静脉滴注(250 mg,qd),并联合多西环素口服(100 mg,qd);试验组在对照组用药的基础上,加用甲硝唑口服治疗(400 mg,tid),均治疗21 d。比较2组的总有效率,细胞因子、免疫功能及血液流变学指标水平。结果试验组总有效率为93%,明显高于对照组的74%(P <0.05)。治疗后,试验组单核细胞趋化蛋白-1(MCP-1)、C反应蛋白(CRP)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平显著低于对照组(P <0.05);试验组CD3^+、CD4^+T淋巴细胞及CD4^+/CD8^+比值水平显著高于对照组(P <0.05),且CD8^+T淋巴细胞水平明显降低(P <0.05);试验组患者低切全血黏度、高切全血黏度、血浆黏度、红细胞沉降率、血细胞比容显著低于对照组(P <0.05)。结论甲硝唑联合头孢曲松、多西环素治疗盆腔炎具有较好的疗效,该疗法可调节细胞因子水平,减轻炎症反应,提高免疫功能,改善血液流变学。

AIM To analyze the clinical effects of metronidazole combined with ceftriaxone and doxycycline in the treatment of pelvic inflammatory disease and its influence on cytokines, immune function and hemorheology.METHODS A total of 95 patients with pelvic inflammatory disease were randomly divided into control group(n=50) and experimental group(n=45). The control group was given ceftriaxone intravenous drip(250 mg, qd)combined with doxycycline oral administration(100 mg, qd);the experimental group was treated with metronidazole oral administration(400 mg,tid) on the basis of the control group.Both groups were treated for 21 days. The total effective rate and indicators related to cytokines, immune function and hemorheology were compared between the two groups. RESULTS The total effective rate of the experimental group was 93%, which was significantly higher than that of the control group(74%, P < 0.05). After the treatment, the levels of monocyte chemoattractant protein-1(MCP-1), C-reactive protein(CRP), and granulocyte-macrophage colony stimulating factor(GM-CSF) in the experimental group were significantly lower than those in the control group(P < 0.05). The levels of CD3^+, CD4^+ T lymphocyte and CD4^+/CD8^+ in the experimental group were significantly higher than those in the control group(P < 0.05), and the level of CD8^+ T lymphocyte was obviously reduced(P < 0.05). The low shear whole blood viscosity, high shear whole blood viscosity, plasma viscosity, erythrocyte sedimentation and hematocrit in the experimental group were significantly lower than those in the control group(P < 0.05). CONCLUSION Metronidazole combined with ceftriaxone and doxycycline has a good effect in the treatment of pelvic inflammation, which could regulate the levels of cytokines, reduce the inflammation response, improve the immune function and hemorheology.