感染性脊柱炎治疗的临床疗效

N. Gjermeni, D. Kraja, N. Çomo, A. Harxhi, P. Pipero, A. Simaku
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摘要

摘要:脊柱炎的治疗是感染性脊柱炎(IR)治疗中最困难的方面之一。该研究的目的是确认药物治疗的疗效和治疗IR的相关副作用。材料和方法:该研究包括2006年1月至2015年12月期间在阿尔巴尼亚地拉那大学医院中心传染病服务处就诊的103名患者。根据临床、放射学和微生物学标准诊断感染性脊柱炎。结果:患者平均年龄58.1(±10.4)岁,年龄范围16 ~ 75岁。男性占62%,女性占38%。男女比例为1.6:1。患者的临床神经学症状见表1。37.9%和16.5%的患者以脊柱炎和椎间盘炎为最常见的体征(p<0.01)。56例(54.4%)患者出现不良反应。最常见的是胃肠道疾病(17.5%)、皮肤病(9.7%)、肝病(7.8%)、舌炎(4.9%)。2例(1.9%)死亡,其中1例合并脓毒性休克,另1例合并获得性免疫缺陷综合征。后遗症4例(3.9%)。四肢瘫痪1例,单侧下截瘫2例(1.9%),神经源性膀胱1例(1%)。2例(1.9%)出现疾病复发。这些发现与其他研究中提出的结果相似,表明IR治疗在许多国家是一个复杂而重要的问题。
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Clinical Response to Treatment of Infectious Rachiditis
: Introduction: Spondylodiscites treatment is one of the most difficult aspect of Infectious Rachiditis (IR) management. The aim of the study is to recognize the efficacy of drug therapy and associated side effects of the treatment of IR. Material and methods: The study included 103 patients who presented to Service of Infectious Diseases, at University Hospital Centre in Tirana, Albania over the period January 2006 – December 2015. The diagnosis of infectious rachiditis was made according to clinical, radiological and microbiological criteria. Results: The mean age of patients was 58.1(±10.4) years with a range 16-75 years. 62% were males and 38% females. Male to female ratio is 1.6:1. The clinical neurological signs of patients are presented in table 1. Spondilodiscitis and discitis were most frequent signs in 37.9% and 16.5% patients respectively (p<0.01). Side effects were manifested in 56 (54.4%) of patients. Most frequent ones were gastrointestinal disturbances (17.5%), dermatoses (9.7%), hepatopathy (7.8%), glossitis (4.9%). Two cases (1.9%) had a fatal outcome, one of them had a periaortal abscess complicated to septic shock, while the other case suffered also from acquired immunodeficiency syndrome. Sequelae manifested 4 (3.9%) of the total patients. One case developed tetraplegia, two cases (1.9%) developed inferior unilateral paraplegia, one case (1%) had neurogenic bladder. Two (1.9%) cases manifested relapse of the disease. These findings are similar to those presented in different studies sugesting that IR treatment is a complex and a significant issue in many countries.
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