免疫球蛋白联合美罗培南对新生儿化脓性脑膜炎的疗效观察

Effect of Immunoglobulin Combined with Meropenem in the Treatment of Neonatal Purulent Meningitis

目的:探讨免疫球蛋白联合美罗培南对新生儿化脓性脑膜炎的临床疗效。方法:选取2018年4月-2021年3月洛阳市妇幼保健院收治的68例化脓性脑膜炎新生儿作为研究对象,采用随机数表法分为研究组(n=34)与对照组(n=34)。对照组予以美罗培南治疗,研究组在对照组基础上予以免疫球蛋白治疗。比较两组患儿的临床症状改善时间、血清炎症因子、脑脊液神经营养因子。结果:研究组治疗后的血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-1β(Interleukin-1β,IL-1β)、白介素-6(Interleukin-6,IL-6)、高敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)水平显著低于对照组,差异有统计学意义(t=6.409、7.441、11.056、5.926,P<0.05);研究组治疗后的脑脊液胰岛素样生长因子Ⅱ(IGF-Ⅱ)、神经元特异性烯醇化酶(NSE)、S100β蛋白(S-100β)水平显著显著低于对照组,差异有统计学意义(t=9.540、12.232、11.527,P<0.05);研究组患儿的脑膜刺激征消失时间、惊厥停止时间、体温稳定时间、脑脊液复常时间、住院时间均显著短于对照组,差异有统计学意义(t=15.971、6.478、7.545,P<0.05)。结论:免疫球蛋白联合美罗培南治疗可有效减轻化脓性脑膜炎新生儿的机体炎症反应,改善其神经功能,控制惊厥症状,疗效确切。

Objective: To investigate the clinical efficacy of immunoglobulin combined with meropenem in the treatment of neonatal purulent meningitis. Methods: 68 cases of neonates with septic meningitis admitted to the hospital from April 2018 to March 2021 were selected as the study subjects and were divided into study and control groups using the random number table method,with 34 cases in each group. The control group was treated with meropenem and the study group was treated with immunoglobulin on top of the control group. The time to improvement of clinical symptoms, serum inflammatory factors, and cerebrospinal fluid neurotrophic factors in the two groups of children were compared. Results: The serum tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), and hypersensitive C-reactive protein(hs-CRP) levels in the study group were statistically significantly lower than those in the control group after treatment, with statistically significant differences(t=6.409, 7.441, 11.056, 5.926,P<0.05). Cerebrospinal fluid insulin-like growth factor Ⅱ(IGF-Ⅱ), neuron-specific enolase(NSE), and S100β protein(S-100β)levels were significantly and significantly lower in the study group than in the control group after treatment, with statistically significant differences(t=9.540, 12.232, 11.527, P<0.05). The time to disappearance of meningeal stimulation signs, time to cessation of convulsions, time to temperature stabilization, time to cerebrospinal fluid normalization, and time to hospitalization were significantly shorter in the study group than in the control group, with statistically significant differences(t=15.971, 6.478, 7.545, P<0.05).Conclusion: Immunoglobulin combined with meropenem treatment can effectively reduce the inflammatory response, improve neurological function and control convulsions in neonates with septic meningitis, with definite efficacy.