不同抗菌药物方案在中枢神经系统感染性疾病治疗中的应用效果比较  

Comparison of the efficacy of different antimicrobial regimens in the treatment of central nervous system infectious diseases

作　　者：张永杰 王兴华 黄晓岚 ZHANG Yongjie;WANG Xinghua;HUANG Xiaolan(Department of Pharmacy,Kaiping Center Hospital,Jiangmen,Guangdong 529300,China)

机构地区：[1]开平市中心医院药剂科,广东江门529300

出　　处：《医药前沿》2024年第29期28-30,34,共4页Journal of Frontiers of Medicine

摘　　要：目的:比较万古霉素联合抗假单胞菌的β-内酰胺类方案、哌拉西林他唑巴坦钠联合舒巴坦方案在中枢神经系统感染性疾病治疗中的应用效果。方法:选取2021年3月—2023年9月开平市中心医院收治的82例中枢神经系统感染性疾病患者作为研究对象,根据不同用药方案进行分组,A组41例采用万古霉素联合抗假单胞菌的β-内酰胺类治疗,B组41例采用哌拉西林他唑巴坦钠联合舒巴坦治疗。比较两组治疗效果、症状改善时间、炎性因子及不良反应。结果:A组总有效率高于B组,体温恢复正常时间、实验室检查恢复正常时间均短于B组,差异有统计学意义(P<0.05)。治疗7 d后,A组C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)指标水平均低于B组,差异有统计学意义(P<0.05)。A组治疗期间不良反应总发生率高于B组,差异有统计学意义(P<0.05)。结论:万古霉素联合抗假单胞菌的β-内酰胺类方案治疗中枢神经系统感染性疾病见效快,能够快速改善症状,抑制炎性因子表达,但是不良反应较多,临床可根据患者具体情况选择适合的抗菌药物方案。Objective To compare the efficacy of vancomycin combined withβ-lactam agents effective anti-Pseudomonas aeruginosa versus piperacillin-tazobactam combined with sulbactam in the treatment of central nervous system infectious diseases.Methods A total of 82 patients with central nervous system infectious diseases admitted to Kaiping Central Hospital from March 2021 to September 2023 were selected as the study subjects.The patients were divided into two groups based on different medication regimens.Group A(41 patients)received vancomycin combined withβ-lactam agents effective anti-Pseudomonas aeruginosa,while Group B(41 patients)received piperacillin-tazobactam combined with sulbactam.The treatment efficacy,time to symptom improvement,inflammatory markers and adverse reactions were compared between the two groups.Results The overall effective rate in Group A was higher than that in Group B.The time to normalization of body temperature and laboratory tests was shorter in Group A compared to Group B,with statistically significant differences(P<0.05).7 days after treatment,the levels of C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)in Group A were lower than those in Group B,with statistically significant differences(P<0.05).The total incidence of adverse reactions during treatment was higher in Group A than in Group B,with statistically significant differences(P<0.05).Conclusions Vancomycin combined with anti-Pseudomonasβ-lactam regimen in the treatment of central nervous system infectious diseases is effective,can quickly improve the symptoms,inhibit the expression of inflammatory factors,but more adverse reactions,clinical can be selected according to the specific conditions of patients with appropriate antimicrobial regimens.

关 键 词：中枢神经系统感染性疾病 万古霉素 抗假单胞菌的β-内酰胺类方案 

分 类 号：R63[医药卫生—外科学]