膦甲酸钠联合常规西药治疗人巨细胞病毒感染相关性进展性脑卒中的临床研究

A clinical study on the treatment of HCMV infection-related stroke in progression with sodium phosphonate combined with conventional western medicine

摘要:

目的 探讨膦甲酸钠（PFA）联合常规西药治疗人巨细胞病毒感染相关性进展性脑卒中的临床疗效。方法 回顾性分析2017年1月—2019年1月于天津海滨人民医院接受治疗的150例HCMV感染相关性进展性脑卒中患者的临床资料。接受常规西药治疗的72例患者为对照组，接受PFA联合常规西药治疗的78例患者为观察组。比较两组患者治疗前、治疗第14天的美国国立卫生研究院卒中量表（NIHSS）评分，两组患者治疗第7天、第14天外周血白细胞人巨细胞病毒-pp65（HCMV-pp65）抗原转阴率，两组患者的临床疗效和治疗前、治疗第14天的血清C-反应蛋白（CRP）、白细胞介素-6（IL-6）、溶血磷脂酸（LPA）水平，两组患者治疗期间的不良反应情况。结果 两组治疗第14天NIHSS评分较治疗前均降低（P <0.05），且观察组NIHSS评分低于对照组（P <0.05）；两组治疗第7天、第14天HCMV-pp65抗原转阴率比较，差异无统计学意义（P >0.05），两组HCMV-pp65抗原总转阴率比较，观察组高于对照组（P <0.05）；两组临床疗效比较，差异有统计学意义（P <0.05），观察组总有效率高于对照组（P <0.05）；两组治疗第14天血清CRP、IL-6、LPA水平较治疗前均降低（P <0.05），且观察组均低于对照组（P <0.05）；两组治疗期间不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 PFA联合常规西药治疗人巨细胞病毒感染相关性进展性脑卒中可有效改善患者神经功能，具有较好的抗人巨细胞病毒感染功能和较高的临床疗效，可有效降低患者血清CRP、IL-6、LPA水平，安全性高。

Abstract:

Objective To explore the clinical effect of phosphonate-sodium (PFA) combined with conventional western medicine in the treatment of human cytomegalovirus (HCMV) infection-related progressive stroke (SIP).Methods The clinical data of 150 HCMV infection-related progressive stroke patients treated in our hospital from January 2017 to January 2019 were retrospectively analyzed. The 72 patients received conventional western medicine treatment were enrolled in the B group, and the 78 patients received PFA combined with conventional western medicine treatment were enrolled in the A group. The national institutes of health stroke scale (NIHSS) scores before and after treatment between the 2 groups were compared, and the negative conversion rates of HCMV-pp65 antigen in peripheral blood cells at 7thd, 14th d after treatment and after 14d treatment between the 2 groups were compared. The clinical efficacy between the 2 groups and the patients' serum levels of C-reactive protein (CRP), Interleukin-6 (IL-6) and lysophosphatidic acid (LPA) before and after treatment were compared. Adverse reactions occurred during treatment between the 2 groups were compared.Results NIHSS scores after treatment of both groups decreased (P < 0.05), and NIHSS score of the A group was lower than that of the B group (P < 0.05). There were no significant differences in the negative conversion rates of HCMV-pp65 antigen between the 2 groups at 7thd, 14thd (P > 0.05). The total negative conversion rate of HCMV-pp65 antigen of the combined group was higher than that of the B group (P < 0.05). There was a statistically significant difference in the distribution of clinical efficacy grades between the 2 groups (P < 0.05), and the total effective rate of the combined group was higher than that of the B group (P < 0.05). The serum CRP, IL-6 and LPA level of the 2 groups decreased after treatment (P < 0.05), of which the combined group were lower than the B group (P < 0.05). The incidence of adverse reactions during treatment of A group was similar to which of the B group (P > 0.05).Conclusion PFA combined conventional western medicine treatment of HCMV infection related progressive stroke can effectively improve nerve function of patients, compared with only using conventional western medicine, this treatment has good function of anti HCMV infection and higher clinical curative effect, and it can effectively reduce the patients' serum CRP, LPA, IL-6 levels and increased significantly during treatment in patients with high safety.