替加环素和头孢他啶阿维巴坦钠鞘内注射治疗神经介入术后颅内感染的效果及对脑脊液NSE Ang-Ⅱ和MDA的影响

Efficacy of tigacycline,ceftazidime and avibactam sodium intrathecal injection in the treatment of intracranial infection after neurointerventional therapy and its effect on cerebrospinal fluid NSE,Ang-Ⅱand MDA

目的探讨替加环素和头孢他啶阿维巴坦钠鞘内注射治疗神经介入术后颅内感染患者的效果及对脑脊液神经特异性烯醇化酶(NSE)、血管紧张素Ⅱ(Ang-Ⅱ)、丙二醛(MDA)的影响。方法选取山东第一医科大学附属人民医院2019-01—2021-06经替加环素鞘内注射治疗的神经介入术后颅内感染患者20例为A组,2022-01—2023-06经头孢他啶阿维巴坦钠鞘内注射治疗的神经介入术后颅内感染患者44例为B组。比较2组患者脑脊液NSE、Ang-Ⅱ、MDA水平,血清炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、降钙素元(PCT)、外周血中性粒细胞比例(NEU%)],临床有效率,细菌清除情况及不良反应。结果2组患者脑脊液NSE、Ang-Ⅱ、MDA水平比较差异无统计学意义(P>0.05)。2组患者血清CRP、PCT、WBC及NEU%比较差异无统计学意义(P>0.05)。2组临床有效率比较差异无统计学意义(P>0.05)。2组细菌清除率、细菌再感染率及细菌替换率比较差异无统计学意义(P>0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论头孢他啶阿维巴坦钠与替加环素鞘内注射治疗神经介入术后颅内感染均能显著消除脑脊液病原菌,降低炎症因子水平,改善神经损伤,临床有效率较高。临床可对耐药性较强的患者进行头孢他啶阿维巴坦钠鞘内注射治疗。

Objective To investigate the therapeutic effect of tigacycline,ceftazidime and avibactam sodium intrathecal injection in the treatment of intracranial infection after neurointerventional therapy and the effects on neurospecific enolase(NSE),angiotensinⅡ(Ang-Ⅱ)and malondialdehyde(MDA)in cerebrospinal fluid.Methods A total of 20 patients with intracranial infection who received intrathecal injection of tigacycline treated in the People’s Hospital Affiliated to Shandong First Medical University from January were selected as group A,and 44 patients with intracranial infection who received intrathecal injection of ceftazidime and avibatan sodium treated in our hospital from January 2022 to June 2023 were selected as group B.The levels of NSE,Ang-Ⅱand MDA in cerebrospinal fluid,serum inflammatory indicators(white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),peripheral blood neutrophils ratio(NEU%)),clinical effective rate,bacterial clearance and adverse reactions were compared between the two groups.Results There were no significant differences in NSE,Ang-Ⅱand MDA levels between the two groups(P>0.05).There were no significant differences in serum CRP,PCT,WBC and NEU%between the two groups(P>0.05).There was no significant difference in clinical effective rate between the two groups(P>0.05).There was no significant difference in bacterial clearance rate,bacterial reinfection rate and bacterial replacement rate between the two groups(P>0.05).There was no statistical significance in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ceftazidime and avibactam sodium and tigacycline intrathecal injection for intracranial infection after neurointerventional treatment can significantly eliminate cerebrospinal fluid pathogens,reduce inflammatory factors,improve nerve damage,and increase clinical effective rate.Ceftazidime and tigacycline sodium intrathecal injection can be used to treat the patients with strong drug resistance.