糖皮质激素对结核性脑膜炎患者的临床疗效及脑脊液指标的影响(1)
【摘要】 目的：探討糖皮质激素对结核性脑膜炎患者的临床疗效及脑脊液指标的影响。方法：采取回顾性研究的方法，收集2013年1月-2018年12月医院收治的结核性脑膜炎患者67例，根据不同治疗方案分为两组，无糖皮质激素组31例给予2HREZ/4HR方案治疗，总疗程为6～12个月;糖皮质激素组在2HREZ/4HR方案治疗的基础上加用糖皮质激素治疗(疗程3个月)，总疗程为6～12个月。比较两组患者的治疗效果、临床症状改善情况、不良反应及脑脊液指标。结果：治疗3个月后，糖皮质激素组总有效率为91.67%，无糖皮质激素组总有效率为70.97%，糖皮质激素组明显高于无糖皮质激素组，差异有统计学意义(P<0.05);糖皮质激素组头晕、头痛、发热比例明显低于无糖皮质激素组(P<0.05);糖皮质激素组蛋白质、白细胞计数明显低于无糖皮质激素组，葡萄糖、氯化钠明显高于无糖皮质激素组(P<0.05);两组患者腹泻、关节疼痛、肝功能异常及消化道出血发生率比较，差异均无统计学意义(P>0.05)。结论：在常规抗结核治疗的基础上加用糖皮质激素，明显提高了结核性脑膜炎的治疗效果，改善了临床症状体征，减轻了脑脊液细胞学损伤和炎症反应，且未增加不良反应。
【关键词】 结核性脑膜炎 糖皮质激素 2HREZ/4HR方案 临床疗效 脑脊液细胞学
[Abstract] Objective： To investigate the effect of glucocorticoid on clinical effect and cerebrospinal fluid index in the treatment of tuberculous meningitis. Method： A retrospective study was conducted， 67 patients with tuberculous meningitis admitted to the hospital from January 2013 to December 2018 were collected， the patients were divided into two groups according to the different treatments. Non-glucocorticoid group (n=31) was treated with 2HREZ/4HR regimen， the total course of treatment was 6 to 12 months. Glucocorticoid group was treated with glucocorticoid based on the treatment of 2HREZ/4HR regimen (3 months of treatment)， the total course of treatment was 6 to 12 months. The therapeutic effect， clinical symptoms， adverse reactions and cerebrospinal fluid index were compared between the two groups. Result： After 3 months of treatment， the total effective rate of glucocorticoid group was 91.67%， non-glucocorticoid group was 70.97%， the total effective rate of glucocorticoid group was significantly higher than that of non-glucocorticoid group， the difference was statistically significant (P<0.05). The proportion of dizziness， headache and fever of glucocorticoid group were significantly lower than those of non-glucocorticoid group (P<0.05). The protein， white blood cell count of glucocorticoid group were significantly lower than those of non-glucocorticoid group， and glucose and sodium chloride were significantly higher than those of non-glucocorticoid group (P<0.05). There were no significant differences in the incidence of diarrhea， arthralgia， liver dysfunction and gastrointestinal bleeding between the two groups (P>0.05). Conclusion： On the basis of routine anti tuberculosis therapy combined with glucocorticoid significantly improves the tuberculous meningitis treatment effect， improve clinical symptoms， reduce the cerebrospinal fluid cytology injury and inflammation， and there is no increase in adverse reactions., http://www.100md.com(孔波 杨婵)
【关键词】 结核性脑膜炎 糖皮质激素 2HREZ/4HR方案 临床疗效 脑脊液细胞学
[Abstract] Objective： To investigate the effect of glucocorticoid on clinical effect and cerebrospinal fluid index in the treatment of tuberculous meningitis. Method： A retrospective study was conducted， 67 patients with tuberculous meningitis admitted to the hospital from January 2013 to December 2018 were collected， the patients were divided into two groups according to the different treatments. Non-glucocorticoid group (n=31) was treated with 2HREZ/4HR regimen， the total course of treatment was 6 to 12 months. Glucocorticoid group was treated with glucocorticoid based on the treatment of 2HREZ/4HR regimen (3 months of treatment)， the total course of treatment was 6 to 12 months. The therapeutic effect， clinical symptoms， adverse reactions and cerebrospinal fluid index were compared between the two groups. Result： After 3 months of treatment， the total effective rate of glucocorticoid group was 91.67%， non-glucocorticoid group was 70.97%， the total effective rate of glucocorticoid group was significantly higher than that of non-glucocorticoid group， the difference was statistically significant (P<0.05). The proportion of dizziness， headache and fever of glucocorticoid group were significantly lower than those of non-glucocorticoid group (P<0.05). The protein， white blood cell count of glucocorticoid group were significantly lower than those of non-glucocorticoid group， and glucose and sodium chloride were significantly higher than those of non-glucocorticoid group (P<0.05). There were no significant differences in the incidence of diarrhea， arthralgia， liver dysfunction and gastrointestinal bleeding between the two groups (P>0.05). Conclusion： On the basis of routine anti tuberculosis therapy combined with glucocorticoid significantly improves the tuberculous meningitis treatment effect， improve clinical symptoms， reduce the cerebrospinal fluid cytology injury and inflammation， and there is no increase in adverse reactions., http://www.100md.com(孔波 杨婵)
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