多黏菌素B鞘内/脑室内注射对颅内肿瘤术后颅内感染脑脊液miR-21、miR-155、miR-92b水平的影响

Influence of intrathecal/intracerebroventricular injection of polymyxin B on cerebrospinal fluid miR-21,miR-155 and miR-92b of intracranial tumor patients with postoperative intracranial infection

目的探讨多黏菌素B鞘内/脑室内注射对颅内肿瘤术后颅内感染脑脊液微小核糖核酸-21(miR-21)、miR-155、miR-92b水平的影响。方法将68例2020年8月-2023年8月山东第一医科大学附属人民医院收治的颅内肿瘤术后颅内感染患者按照治疗方案的不同分为对照组和研究组,各34例。两组均给予腰大池置管引流治疗,对照组在此基础上给予注射用硫酸多黏菌素B静脉注射治疗,研究组在对照组的基础上给予注射用硫酸多黏菌素B鞘内/脑室内注射治疗,均治疗2周。比较两组疗效、症状控制情况、住院时间、脑脊液生化指标、炎性因子、miR-21、miR-155、miR-92b水平及不良反应。结果较对照组,研究组治疗2周后疗效率更高(P<0.05)。较对照组,研究组感染控制、退热及住院时间更短(P<0.05)。治疗2周后,两组脑脊液白细胞、有核细胞、蛋白质、腺苷脱氢酶、白细胞介素-6(IL-6)、降钙素原(PCT)、γ-干扰素(IFN-γ)、C-反应蛋白(CRP)、miR-21、miR-155、miR-92b较治疗前降低(P<0.05),研究组更低(P<0.05)。两组治疗期间均未出现明显不良反应。结论多黏菌素B鞘内/脑室内注射可降低颅内肿瘤术后颅内感染患者脑脊液miR-21、mir-155、miR-92b及生化指标水平,减轻炎症,进而可促进症状控制,缩短住院时间,提高疗效,且并未明显增加患者的不良反应。

OBJECTIVE To explore the influence of intrathecal/intracerebroventricular injection of polymyxin B on the cerebrospinal fluid microribonucleic acid-21(miR-21),miR-155 and miR-92b of the intracranial tumor patients with postoperative intracranial infection.METHODS Totally 68 intracranial tumor patients with postoperative intracranial infection who were treated in Shandong First Medical University Affiliated People′s Hospital from Aug.2020 to Aug.2023 were enrolled in the study and were divided into the control group and the study group according to the treatment programs,with 34 cases in each group.Both groups were treated with lumbar cistern drainage,the control group was given additional intravenous injection of polymyxin B sulfate,and the study group was given additional intrathecal/intracerebroventricular injection of polymyxin B sulfate on basis of the treatment of the control group,and both groups were treated for 2 weeks.The curative effect,control status of symptoms,length of hospital stay,cerebrospinal fluid biochemical indexes,inflammatory factors,miR-21,miR-155,miR-92b and incidence of adverse reactions were observed and compared between the two groups.RESULTS The total effective rate of trentment of the study group was higher than that of the control group after the treatment for 2 weeks(P<0.05).The time of infections under control,fever abatement and length of hospital stay were shorter in the study group than in the control group(P<0.05).The levels of cerebrospinal fluid leukocytes,nucleated cells,proteins,adenosine dehydrogenase,interleukin-6(IL-6),procalcitonin(PCT),interferon-γ(IFN-γ),C-reactive protein(CRP),miR-21,miR-155 and miR-92b of the two groups were lower after the treatment for 2 weeks than before the treatment(P<0.05),and the levels of the above indexes of the study group were lower than those of the control group(P<0.05).There were no significant adverse reactions in the two groups during the treatment period.CONCLUSION The intrathecal/intracerebroventricular injection of polymyxin B can reduce the levels of cerebrospinal fluid miR-21,miR-155,miR-92b and biochemical indexes of the intracranial tumor patients with postoperative intracranial infection,alleviate the inflammations,promote the control of symptoms,shorten the length of hospital stay,and improve the curative effect without the increase of adverse reactions.