两性霉素B治疗真菌性脑膜炎合并脑积水患者效果评价  

Evaluation on the Effect of Amphotericin B in the Treatment of Patients with Fungal Meningitis Complicated with Hydrocephalus

作　　者：杨成 刘志罡 YANG Cheng;LIU Zhigang(Department of Neurosurgery,Beijing North Asia Orthopaedic Hospital,Beijing 102445,China;不详)

机构地区：[1]北京北亚骨科医院神经外科,北京102445

出　　处：《中国医学创新》2025年第12期25-29,共5页Medical Innovation of China

摘　　要：目的:探究两性霉素B治疗真菌性脑膜炎合并脑积水的效果。方法:将2020年1月—2023年12月北京北亚骨科医院的80例真菌性脑膜炎合并脑积水患者根据随机数字表法分为对照组40例和观察组40例。对照组采用氟康唑与氟胞嘧啶进行治疗,观察组则在对照组的基础上加用两性霉素B。比较两组治疗10周后的治疗效果、各类不良反应的发生率、治疗前后的颅内压、脑脊液常规生化指标(白细胞计数、蛋白含量及糖水平)及Th类细胞因子[白介素-6(IL-6)、白介素-8(IL-8)、白介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)]。结果:观察组的总有效率显著高于对照组,差异有统计学意义(P<0.05),两组的各类不良反应发生率比较,差异均无统计学意义(P>0.05),治疗前两组的颅内压、脑脊液常规生化指标及Th类细胞因子比较,差异均无统计学意义(P>0.05),治疗4周及8周后观察组的颅内压、白细胞计数、蛋白含量及Th类细胞因子均显著低于对照组,糖水平均显著高于对照组,差异均有统计学意义(P<0.05)。结论:在氟康唑与氟胞嘧啶治疗的基础上加用两性霉素B治疗真菌性脑膜炎合并脑积水患者的效果较好,可显著改善脑脊液常规生化指标及Th类细胞因子,因此在真菌性脑膜炎合并脑积水患者中的应用价值较高。Objective:To investigate the effect of Amphotericin B in the treatment of patients with fungal meningitis complicated with hydrocephalus.Method:A total of 80 patients with fungal meningitis complicated with hydrocephalus in Beijing North Asia Orthopaedic Hospital from January 2020 to December 2023 were divided into control group 40 cases and observation group 40 cases according to the random number table method.The control group was treated with Fluconazole and Flucytosine,the observation group was treated with Amphotericin B on the basis of control group.Then the treatment effect after ten weeks,various adverse reactions rates,intracranial pressure,cerebrospinal fluid routine biochemical indexes(white blood cell count,protein content and glucose level)and Th cytokines[interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)]before and after the treatment of two groups were compared.Result:The total effective rate of observation group was significantly higher than that of control group,the difference was statistically significant(P<0.05),while the various adverse reactions rates of two groups were compared,the differences were not statistically significant(P>0.05),the intracranial pressure,cerebrospinal fluid routine biochemical indexes and Th cytokines of two groups before the treatment were compared,the differences were not statistically significant(P>0.05),the intracranial pressure,cerebrospinal fluid white blood cell count,protein content and Th cytokines of observation group at forth and eighth week after the treatment were significantly lower than those of control group,the glucose levels were significantly higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:The effect of Amphotericin B on the basis of Fluconazole and Flucytosine in patients with fungal meningitis complicated with hydrocephalus is better,and it can significantly improve the cerebrospinal fluid routine biochemical indexes and Th cytokines of patients,so

关 键 词：两性霉素B 真菌性脑膜炎 脑积水 

分 类 号：R519[医药卫生—内科学]