第三代头孢菌素结合免疫球蛋白治疗小儿化脓性脑膜炎的临床疗效OA

Objective To explore the therapeutic effects of third-generation cephalosporins combined with immunoglobulins in pediatric purulent meningitis.Methods A total of 104 children with purulent meningitis treated at our hospital from January 2020 to January 2023 were selected.They were divided into a control group and an observation group using the random number table,with 52 children in each.The control group received ceftriaxone sodium,while the observation group received ceftriaxone sodium and immunoglobulin.Both groups received treatment with ceftriaxone for 14 days,while the observation group received treatment with immunoglobulin for 5 days.The clinical efficacy and symptom resolution time(time to consciousness improvement and defervescence)were recorded for the two groups of pediatric patients.The levels of serum inflammatory factors[tumor necrosis factor-alpha(TNF-α),interleukin-1 beta(IL-1β),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],T cell subsets(CD3+,CD4+,CD8+),and cerebrospinal fluid(CSF)biochemical markers(white blood cell count,glucose quantification,protein quantification,neuron-specific enolase,S100β protein)were compared before and after treatment.Results The observation group exhibited a higher overall effective rate than the control group(P<0.05).The observation group showed shorter times to consciousness improvement and defervescence compared with the control group(P<0.05).After treatment,levels of TNF-α,IL-1β,IL-6,and hs-CRP were lower in the observation group than in the control group(P<0.05).Both groups exhibited significant decreases in TNF-α,IL-1β,IL-6,and hs-CRP after treatment compared with baseline(P<0.05).The pre-to post-treatment changes in TNF-α,IL-1β,IL-6,and hs-CRP were greater in the observation group than in the control group(P<0.05).After treatment,the observation group had higher CD3+and CD4+levels and lower CD8+levels compared with the control group(P<0.05).Both groups showed increases in CD3+and CD4+and decreases in CD8+after treatment compared with baseline(P<0.05).The pre-to post-treatment changes in CD3+,CD4+,and CD8+levels were greater in the observation group than in the control group(P<0.05).Following treatment,the observation group also exhibited lower white blood cell counts,lower levels of total protein,NSE,and S-100β,and higher glucose levels compared with the control group(P<0.05).Both groups showed decreases in white blood cell counts and levels of total protein,NSE,and S-100β,and increases in glucose after treatment compared with baseline(P<0.05).The pre-to post-treatment changes in white blood cell counts and levels of glucose,total protein,NSE,and S-100β were greater in the observation group than in the control group(P<0.05).Conclusion The combination of ceftriaxone sodium and immunoglobulin enhances the treatment efficacy of pediatric purulent meningitis.