摘要
目的 探讨高压氧（hyperbaric oxygen,HBO）联合万古霉素治疗金黄色葡萄球菌感染性心内膜炎（staphylococcus aureus infective endocarditis,SAIE）的临床疗效.方法 选取2015年1月至2017年1月在复旦大学附属华东医院心内科接受治疗的SAIE患者88例,按照治疗方法将其分为试验组和对照组,对照组在常规治疗的基础上给予万古霉素治疗,试验组在对照组治疗的基础上给予HBO治疗.治疗结束后,比较2组患者治疗的有效率、细菌转阴率、不良反应发生率及患者血清中相关细胞因子,如白细胞介素（interleukin,IL）-6、8、10,血管内皮生长因子（vascular endothelial growth factor,VEGF）,肿瘤坏死因子（tumor necrosis factor-α,TNF-α）,干扰素（interferon-γ,IFN-γ）表达水平的差异.结果 试验组治疗有效率及细菌转阴率明显高于对照组,差异有统计学意义（P＜0.05）.观察组不良反应率低于对照组,但差异无统计学意义（P＞0.05）.与对照组比较,患者血清中IL-6、IL-8及VEGF水平显著降低,差异有统计学意义（P＜0.05）.结论 HBO能够增强万古霉素治疗SAIE的临床疗效,具有较高的临床应用价值,值得临床进一步推广.
Objective To explore the clinical effects of hyperbaric oxygen （HBO） coupled with vancomycin in the treatment of staphylococcus aureus infective endocarditis （SALE）.Methods Eighty-eight SAIE patients who received treatment in the department of cardiovasology of the hospital from January 2015 to January 2017 were recruited as study subjects and were divided into the observation group and control group according to different treatment methods.In addition to routine treatment,the control group was given vancomycin,while the observation group received HBO therapy on the basis of the treatment received by the control group.After treatment,therapeutic efficacy,bacterial negative turn rate,rate of adverse reactions and the expression levels of related serum cytokines （IL-6,IL-8,IL-10,VEGF,TNF-α and IFN-γ） were compared between the 2 groups The efficiency,rate of adverse reactions and related serum cytokines levels （IL-6、IL-8 、IL-10、VEGF、TNF-α、IFN-γ） were compared between the 2 groups.Results The therapeutic efficacy and bacterial negative turn rate of the observation group were respectively 63.6％ and 72.7％,which were significantly higher than those of the control group,and statistical significance could be seen when comparisons were made between the 2 groups （P ＜ 0.05）.The rate of adverse reactions in the observation group （22.7％） was lower than that in the control group,but without statistical significance （P ＞ 0.05）.The expression levels of serum IL-6,IL-8 and VEGF were significantly lower than those of the control group,with statistical significance （P ＜ 0.05）.Conclusions HBO therapy could augment the efficacy of vancomycin in the treatment of SAIE,and this treatment profile has its important value in clinical practice and is worth further clinical promotion.
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2017年第5期377-380,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
