糖皮质激素治疗结核性脑膜炎的临床疗效

The clinical efficacy of glucocorticoid in the treatment of tuberculous meningitis

目的探讨糖皮质激素冲击治疗结核性脑膜炎患者的临床效果和安全性。方法选取我院收治的80例结核性脑膜炎患者为研究对象,采用完全随机分组方法分为观察组(糖皮质激素冲击+抗结核实验组)40例和对照组(单纯抗结核实验组)40例,观察2组间实验指标,比较2组治疗效果。结果观察组好转率95.0%,显著高于对照组80.0%,差异有统计学意义(P<0.05);观察组脑脊液细胞数和蛋白质含量均较对照组降低明显,且差异有统计学意义(P<0.05);观察组脑脊液葡萄糖和氯化物含量均较对照组显著升高,差异有统计学意义(P<0.05);观察组发热、脑膜刺激征、颅内高压、昏迷症状消失时间明显早于对照组,差异均有统计学意义(P<0.05)。结论糖皮质激素冲击治疗可有效改善结核性脑膜炎患者病情,提升治疗效果,改善患者预后。

Objective To explore the clinical effect and safety of glucocorticoid pulse therapy in patients with tuberculous meningitis. Methods Eighty cases with tuberculous meningitis were selected as research objects and were randomly divided into observation group（glucoeorticoid pulse therapy ＋ anti-tuberculosis treatment, 40 cases）and control group（only antituberculosis treatment, 40 cases）. Then we observed laboratory index to compare the clinical efficacy of two groups. Results The improvement rate of the observation group was 96.7%, significantly higher than the 75.0% in the control group（P〈0.05）. In addition, the observation group has higher glucose and chloride content but lower cell count and protein content in cerebrospinal fluid compared with the control group（P〈0.05）. And the disappearing time of fever, meningeal irritation, intracranial hypertension and coma in the observation group were significantly less than those in the control group（P〈0.05）. Conclusion Glucocorticoid pulse therapy can effectively improve the condition, enhance the effect of anti-tuberculosis treatment and improve the prognosis of tuberculous meningitis.