七叶皂苷钠联合头孢曲松治疗细菌性脑膜炎的效果分析

Analysis on the effects of aescin combined with ceftriaxone in the treatment of bacterial meningitis

目的 探究七叶皂苷钠联合头孢曲松治疗细菌性脑膜炎(bacterial meningitis,BM)的临床效果。方法 收集 2019 年 4月至2021年4月宁国市人民医院急诊科收治的BM患者共80例,依照随机抽签法按1∶1比例分为观察组和对照组,每组各40例。对照组采用头孢曲松治疗,观察组采用七叶皂苷钠联合头孢曲松治疗。比较两组临床疗效、症状消失时间、治疗前后炎症因子[降钙素原(procalcitonin,PCT)、白介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、可溶性血管细胞黏附分子1(soluble vascular cell adhesion molecule 1,sVCAM-1)]水平、氧化应激指标[超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、丙二醛(malondialdehyde,MDA)]、脑水肿指标[水通道蛋白4(aquaporin 4,AQP4)、S-100钙结合蛋白(S-100 calcium binding protein,S-100B)]及治疗期间不良反应发生率。结果 观察组总有效率(92.50%)高于对照组(75.00%)(P<0.05);观察组发热消退、颅高压消失、意识恢复、惊厥消失时间短于对照组(P<0.05);治疗后观察组血清PCT、IL-6、CRP、sVCAM-1、AQP4、S-100B水平低于对照组(P<0.05);治疗后观察组血清SOD、GSH-Px水平高于对照组,MDA水平低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 七叶皂苷钠联合头孢曲松治疗BM患者效果显著,可有效改善症状,减轻机体炎症及氧化应激反应,缓解脑水肿,且安全性高。

Objective To explore the clinical effects of aescin combined with ceftriaxone in the treatment of bacterial meningitis(BM).Methods A prospective study was conducted on 80 patients with BM admitted to Ningguo people’s hospital from April 2019 to April 2021.According to the random lottery method,they were divided into observation group and control group at a ratio of 1∶1,with 40 cases in each group.The control group was treated with ceftriaxone,and the observation group was treated with aescin combined with ceftriaxone.We would compare the efficacy,time of symptom disappearance,inflammatory factors before and after treatment[procalcitonin (PCT),interleukin-6(IL-6),C-reactive protein(CRP),soluble vascular cell adhesion molecule 1 (sVCAM-1)],oxidative stress indicators[superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde (MDA)],brain edema index[aquaporin 4(AQP4),S-100 calcium binding protein(S-100B)]and treatment the incidence of adverse reactions during the period.Results The total effective rate of the observation group was 92.50%,higher than that of the control group 75.00%(P<0.05).The observation group had less time of fever resolution,disappearance of intracranial hypertension,recovery of consciousness,and the disappearance of convulsions were shorter time than those in the control group (P<0.05).The levels of serum PCT,IL-6,CRP,sVCAM-1,AQP4,and S-100B in the observation group were lower than those of the control group (P<0.05).After treatment,the serum SOD and GSH-Px levels in the observation group were higher than those in the control group,and the MDA level was lower than that in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusions Aescin combined with ceftriaxone has a significant effect in the treatment of BM patients,which can effectively promote the improvement of symptoms,reduce inflammation and oxidative stress in the body,relieve cerebral edema with high safety.