头孢曲松钠联合地塞米松治疗小儿化脓性脑膜炎疗效及对血清IFN-γIL-4水平的影响  

Efficacy of Ceftriaxone Sodium Combined with Dexamethasone in the Treatment of Children with Purulent Meningitis and Its Effects on Serum IFN-γand IL-4 Levels

作　　者：张静静 贾媛媛 胡苗苗 成胜权 ZHANG Jingjing;JIA Yuanyuan;HU Miaomiao(The First Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army Air Force,Shaanxi Xi'an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院儿科,陕西西安710032

出　　处：《河北医学》2022年第10期1636-1640,共5页Hebei Medicine

基　　金：陕西省重点研发计划项目,(编号:2017SF-098)。

摘　　要：目的:观察头孢曲松钠联合地塞米松治疗小儿化脓性脑膜炎(PM)疗效及对血清干扰素(IFN-γ)、白细胞介素4(IL-4)水平的影响。方法:采用随机数字表随机余数分组法将2019年3月至2022年3月我院收治的96例PM患儿简单随机分为观察组和对照组各48例。两组均予以基础对症治疗,其中对照组联合头孢曲松钠治疗,观察组联合头孢曲松钠+地塞米松治疗,共治疗2周。比较治疗2周后两组临床疗效、症状和体征恢复情况,观察治疗前后,两组炎性因子、血清相关因子水平。结果:观察组治疗2周后临床总有效率高于对照组(97.92%VS87.50%),差异有统计学意义(P<0.05)。观察组退热时间、脑脊液恢复正常时间、外周血白细胞恢复时间分别为(2.34±0.76)d、(7.65±0.83)d、(5.24±1.27)d短于对照组的(3.62±0.81)d、(9.88±1.12)d、(7.18±2.03)d,差异有统计学意义(P<0.05)。治疗2周后,两组血清INF-γ、IL-4、TNF-α、PCT、MMP-9、sB7-H3水平均低于治疗前,观察组与对照组治疗前后差值分别为(4.31±1.08)pg/mL、(53.54±4.17)pg/mL、(91.85±19.90)ng/L、(12.51±2.68)ng/mL、(251.09±24.07)μg/L、(1850.66±269.54)ng/L与(2.97±1.38)pg/mL、(45.83±0.38)pg/mL、(75.98±20.76)ng/L、(8.76±2.79)ng/mL、(204.51±18.88)μg/L、(1320.23±240.71)ng/L,组间比较差异有统计学意义(P<0.05)。结论:头孢曲松钠+地塞米松能缩短PM患儿症状体征恢复时间,降低炎性因子水平,促进患儿康复。Objective:To observe the efficacy of ceftriaxone sodium combined with dexamethasone in the treatment of purulent meningitis(PM)in children and the effects on levels of serum interferon(IFN-γ)and interleukin 4(IL-4).Methods:Using the random remainder grouping method of random number table method,96 children with PM who were admitted to the hospital from March 2019 to March 2022 were randomly divided into the observation group and the control group,with 48 cases in each group.Both groups were given basic symptomatic treatment,and the control group underwent ceftriaxone sodium therapy additionally while the observation group underwent ceftriaxone sodium+dexamethasone therapy additionally,and both group were treated for 2 weeks.After 2 weeks of treatment,the clinical efficacy and recovery status of symptoms and signs of the two groups were compared,and the levels of inflammatory factors and serum related factors were observed in the two groups before and after treatment.Results:After 2 weeks of treatment,the total clinical effective rate of the observation group was higher than that of the control group(97.92%VS 87.50%)(P<0.05).The fever abatement time,cerebrospinal fluid recovery time and recovery time of peripheral blood leukocyte of(2.34±0.76)d,(7.65±0.83)d and(5.24±1.27)d in the observation group were shorter than(3.62±0.81)d,(9.88±1.12)d and(7.18±2.03)d in the control group(P<0.05).After 2 weeks of treatment,serum levels of INF-γ,IL-4,TNF-α,PCT,MMP-9 and sB7-H3 in the two groups were lower than those before treatment,and the differences before and after treatment were statistically significant between the observation group[(4.31±1.08)pg/mL,(53.54±4.17)pg/mL,(91.85±19.90)ng/L,(12.51±2.68)ng/mL,(251.09±24.07)μg/L,(1850.66±269.54)ng/L]and the control group[(2.97±1.38)pg/mL,(45.83±0.38)pg/mL,(75.98±20.76)ng/L,(8.76±2.79)ng/mL,(204.51±18.88)μg/L,(1320.23±240.71)ng/L](P<0.05).Conclusion:Ceftriaxone sodium+dexamethasone can shorten the recovery times of symptoms and signs,reduce the levels of inf

关 键 词：化脓性脑膜炎 头孢曲松钠 地塞米松 INF-Γ IL-4 

分 类 号：R742.9[医药卫生—神经病学与精神病学]