结核性脑膜炎患者地塞米松冲击治疗的临床研究

Clinical study of dexamethasone pulse therapy for tuberculous meningitis

目的研究地塞米松冲击治疗结核性脑膜炎的疗效与安全性,以期寻找治疗结核性脑膜炎的有效治疗方法,提高临床对结核性脑膜炎的治疗水平。方法选择医院2006年6月-2013年6月120例结核性脑膜炎患者,随机分为两组,对照组60例患者给予常规抗结核治疗,观察组60例患者在对照组基础上给予地塞米松冲击治疗,观察两组主要效果指标,对治疗效果及不良反应进行评价,采用SPSS13.0进行分析。结果观察组治愈44例、有效11例,总有效率91.67%;对照组治愈29例、有效19例,总有效率80.00%;观察组治疗效果明显好于对照组,两组比较差异有统计学意义(P<0.05);观察组出现12例不良反应,分别为血尿酸、血糖、电解质异常及消化道出血,不良反应发生率为20.00%;对照组出现13例不良反应,不良反应发生率为21.67%;两组比较差异无统计学意义。结论结核性脑膜炎患者在常规抗结核治疗基础上给予地塞米松冲击治疗可明显提高治疗效果,缩短患者的治疗时间,而且不增加不良反应。

OBJECTIVE To study the impact of dexamethasone treatment for tuberculous meningitis efficacy and safety,so as to find an effective treatment of tuberculous meningitis treatment methods to improve the clinical treatment of tuberculous meningitis level. METHODS A total of 120 cases of tuberculous meningitis from Jun. 2006 to Jun. 2013 in our hospital were randomly divided into two groups. Totally 60 patients in the control group were treated with conventional anti-TB treatment, 60 patients in observation group were given on the basis of con- trol group but with dexamethasone pulse therapy, the main effect of indicators were observed, treatment effect and toxicity were evaluated. SPSS16.0 software was used for statistical analysis. RESULTS A total of 44 cases were cured in observation group, effective in 11 cases, total effective rate 91.67%; control group cured 29 cases, effective in 19 cases, the total efficiency of 80.00% ; observation group was significantly better than the control group （P〈0.05）. In observation group, 12 adcerse cases occurred in blood uric acid, glucose, electrolyte abnormalities and gastrointestinal bleeding, adverse reactions ratio was 20.00 %; control group of 13 cases of adverse reactions occurred, the incidence rate 21.67% ; the two groups had no significant difference. CONCLUSION Tuberculous meningitis patients on the basis of giving conventional anti-TB treatment but also with impact of dexamethasone treatment can significantly improve the therapeutic effect and shorten the patient＇s treatment time, and does not increase in adverse reactions.