莫西沙星联合抗结核药治疗难治性结核性脑膜炎的临床效果

Clinical Effect of Moxifloxacin Combined with Anti-tuberculosis Drugs in the Treatment of Refractory Tuberculous Meningitis

目的 研究莫西沙星与抗结核药物在难治性结核性脑膜炎临床治疗中的应用效果及用药安全性。方法选取2018年6月—2021年12月内蒙古呼伦贝尔市传染病医院收治入院的173例难治性结核性脑膜炎患者作为研究对象。按照随机数字法分为两组,常规组(n=85)采取抗结核治疗措施,研究组(n=88)采取莫西沙星联合抗结核药物治疗措施。对比两组患者治疗前后脑脊液生化指标、治疗总有效率及不良反应发生率。结果 治疗前,两组患者白细胞计数、脑脊液压力、蛋白质、氯化物脑脊液各项生化指标对比,差异无统计学意义(P>0.05);治疗后,研究组患者脑脊液各项生化指标明显改善,且明显优于常规组,差异有统计学意义(P<0.05);研究组患者治疗总有效率(87.50%)明显高于常规组(72.94%),差异有统计学意义(χ^(2)=5.804,P<0.05);两组患者治疗期间,观察全部患者均未出现严重不良反应,研究组患者不良反应发生率(4.54%)明显低于常规组(34.12%),差异有统计学意义(P<0.05)。结论 莫西沙星联合抗结核药物的治疗方案,在难治性结核性脑膜炎患者治疗过程中,能够显著改善患者相关症状,同时可以明显改善脑脊液相关的生化指标,大大降低患者用药期间的不良反应发生率,安全性更可靠。

Objective To study the efficacy and safety of moxifloxacin and anti-tuberculosis drugs in the clinical treatment of refractory tuberculous meningitis.Methods A total of 173 patients with refractory tuberculous meningitis admitted to Hulunbuir Infectious Diseases Hospital in Inner Mongolia from June 2018 to December 2021 were selected as the research subjects. They were divided into two groups according to the random number method. The routine group(n=85) received anti-tuberculosis treatment measures, and the study group(n=88) received moxifloxacin combined with anti-tuberculosis drug treatment measures. The biochemical indexes of cerebrospinal fluid before and after treatment, the total effective rate of treatment and the incidence of adverse reactions were compared between the two groups.Results Before treatment, there was no statistically significant difference in cerebrospinal fluid biochemical indexes of white blood cell count, cerebrospinal fluid pressure, protein, chloride, between the two groups(P>0.05). After treatment, the biochemical indexes of cerebrospinal fluid in the study group were significantly improved, and were significantly better than those in the routine group, the difference was statistical significance(P<0.05). The total effective rate of patients in the study group(87.50%) was significantly higher than that in the routine group(72.94%), and the difference was statistically significant(χ^(2)=5.804, P<0.05). During the treatment period of the two groups of patients,no serious adverse reactions were observed in all patients. The incidence of adverse reactions in the study group(4.54%) was significantly lower than that in the routine group(34.12%), and the difference was statistically significant(P<0.05).Conclusion Moxifloxacin combined with anti-tuberculosis drugs can significantly improve the related symptoms of patients with refractory tuberculous meningitis during the treatment process. At the same time, it can significantly improve the biochemical indicators related to cerebrospinal fluid, greatly reduce the incidence of adverse reactions during the treatment of patients, and has more reliable safety.