头孢曲松钠联合阿立哌唑治疗神经梅毒效果研究

Effect of ceftriaxone sodium combined with aripiprazole in treatment of neurosyphilis

目的探讨头孢曲松钠联合阿立哌唑对神经梅毒患者的临床治疗效果。方法选取2014年1月-2019年2月淄博市第一医院收治的78例神经梅毒患者作为研究对象,按照随机数字表法分为对照组(n=39)和观察组(n=39)。对照组采用青霉素联合阿立哌唑治疗,观察组采用头孢曲松钠联合阿立哌唑治疗,并完成4周治疗及12个月随访。比较2组阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评分、临床疗效总评量表病情严重程度(clinical global impression-severity of illness,CGI-SI)评分、T细胞百分比、细胞因子水平、不良反应及复发情况。结果观察组治疗后4周阴性症状评分、阳性症状评分、一般精神病理症状评分及PANSS总分下降幅度均大于对照组(P均<0.05);观察组治疗后4周CD3^+T细胞、CD4^+T细胞、CD4^+/CD8^+T细胞、IL-2、IL-12水平上升幅度均高于对照组(P均<0.05);观察组治疗后1、2、3、4周CGI-SI评分均低于对照组(P均<0.05);观察组治疗后6个月、12个月复发率均低于对照组(P均<0.05)。结论头孢曲松钠在治疗神经梅毒患者中,能改善患者神经症状,降低患者临床症状评分,提高患者T细胞百分比,改善细胞因子水平,降低治疗后复发率,药物安全性较高,值得推广应用。

Objective To investigate the clinical effect of ceftriaxone sodium combined with aripiprazole in the treatment of neurosyphilis.Methods Seventy-eight neurosyphilis patients in the Zibo First Hospital from January 2014 to February 2019 were selected and randomly divided into control group(n=39)and observation group(n=39).The control group was treated with penicillin combined with aripiprazole,and the observation group was treated with ceftriaxone sodium combined with aripiprazole.All patients have completed 4 weeks of treatment and 12 months of follow-up.The positive and negative syndrome scale(PANSS)score,the clinical global impression-severity of illness(CGI-SI)score,the percentage of T cells,cytokine levels,adverse reactions and recurrence were compared between 2 groups.Results After 4 weeks of treatment,the observation group had a significant decline of negative symptom scores,positive symptom scores,general psychopathological symptom scores and PANSS total scores than the control group(P<0.05);and a significant increase of CD3^+T cells,CD4^+T cells,CD4^+/CD8^+T cells,IL-2,IL-12 levels than the control group(P<0.05);the CGI-SI scores of the observation group at 1,2,3 and 4 weeks of treatment were lower than those of the control group(P<0.05);the recurrence rate of the observation group at 6 months and 12 months after the end of treatment was lower than that of the control group(P<0.05).Conclusions In the treatment of neurosyphilis patients,ceftriaxone sodium can improve the neurological symptoms of patients,reduce the clinical symptom score,increase the percentage of T cells,improve the level of cytokines,reduce the recurrence rate after treatment and show a high safety.Therefore it deserves clinical promotion and application.