初治肺结核并结核性脑膜炎156例疗效分析

Therapeutic Effect and Evaluation of 156 Initial Treatment of Pulmonary Tuberculosis Combined with Tubercular Meningitis

目的总结初治肺结核并结核性脑膜炎的疗效,探讨抗结核方案对结核性脑膜炎转归的影响。方法回顾性分析我院156例初治肺结核并结核性脑膜炎抗结核治疗及疗效。结果初治抗结核方案(HREZS)有效52例(33.34%),复治抗结核方案(Pas Pto PZA Lfx Am)有效83例(79.81%),治疗无效21例(13.47%)。结论复治方案抗结核治疗有效率明显高于初治方案,晚期结核性脑膜炎治疗效果相对较差。原发耐药率低、易透过血脑屏障的结核药组成合理的抗结核方案治疗,治愈率明显提高,可一定程度改善预后。

Objective To conclude therapeutic effect of the Initial treatment of pulmonary tuberculosis combined with tu-bercular meningitis, and explored how antituberculous plans influence the outcome of tuberculosis meningitis. Methods Retro-spective analysis of the treatment and therapeutic effect on 156 initial treatment of pulmonary tuberculosis combined with tubercular meningitis. Results Valid initial treatment：52（33. 34%）, valid re-treatment：83（79. 81%）, invalid treatment 21（13. 47%）. Conclusion For valid rate of treating tuberculosis meningitis, re-treatment showed a better effect than initial treatment. The valid rate of treating advanced stage of tuberculosis meningitis was not satisfactory. Drug resistance rate performed low at primary stage. Some drugs easily penetrated through blood brain barrier（ BBB） and were composed a reasonable antituberculous plan, which sig-nificantly enhanced the cure rate. To some degree, this plan can improve prognosis.