短期加用利奈唑胺治疗难治性结核性脑膜脑炎的疗效分析

Analysis of the curative effect of treatment of refractory tuberculous meningoencephalitis by short-term addition of llinazolamide

目的观察短期加用利奈唑胺治疗难治性结核性脑膜脑炎的临床疗效及安全性。方法选取2014-09-2018-09郑州市第六人民医院结核科收治的难治性结核性脑膜脑炎患者63例,通过回顾性队列研究将所有患者分为对照组(32例)和治疗组(31例),对照组给予常规抗结核药物加脑脊液置换联合鞘内注药,治疗组在对照组的基础上加用利奈唑胺(LZD,linezolid),治疗4周后分析比较2组总有效率、脑脊液指标(脑脊液压力、脑脊液细胞数、脑脊液蛋白量)、不良反应发生率。结果治疗4周后,治疗组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗组颅内压数值、脑脊液白细胞计数、脑脊液蛋白量均明显低于对照组,差异均有统计学意义(P<0.05)。所有患者治疗过程中均未发生严重不良反应。结论抗结核治疗中短期加用利奈唑胺,可促进难治性结核性脑膜脑炎患者病情恢复,且安全性良好。

Objective To observe the clinical efficacy and safety of the short-term treatment of refractory tuberculous meningoencephalitis with linazolamide.Methods Sixty-three patients with refractory tuberculous meningoencephalitis admitted to the Department of Tuberculosis of the Sixth People's Hospital of Zhengzhou City,2014-09-2018-09 were selected.All patients were divided into control group(32 cases)and treatment group by retrospective cohort study.In 31 cases,the control group was given conventional anti-tuberculosis drugs plus cerebrospinal fluid replacement combined with intrathecal injection.The treatment group was treated with linezolid(LZD,linezolid)on the basis of the control group.After 4 weeks of treatment,the total effective rate of the two groups was Cerebrospinal fluid index(cerebrospinal fluid pressure,number of cerebrospinal fluid cells,cerebrospinal fluid protein),and incidence of adverse reactions were analyzed and compared.Results After 4 weeks of treatment,the total effective rate of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The values of intracranial pressure,leukocyte count of cerebrospinal fluid and protein of cerebrospinal fluid in the treatment group were all significantly lower than those in the control group,and the differences were statistically significant(all P values were<0.05).No serious adverse reactions were observed in all patients.Conclusion The short-term addition of linazolamide in anti-tuberculosis treatment can promote the recovery of refractory tuberculous meningititis patients,and the safety is good.