利奈唑胺联合HRZE方案治疗结核性脑膜脑炎患者的效果

Effects of Linezolid combined with conventional anti-tuberculosis therapy on patients with tuberculous meningitis

目的:观察利奈唑胺联合常规HRZE方案治疗结核性脑膜脑炎患者的效果。方法:回顾性分析2018年2月至2020年11月该院收治的98例结核性脑膜脑炎患者的临床资料,根据治疗方法不同将其分为研究组与对照组各49例。对照组给予常规HRZE方案(异烟肼+利福平+吡嗪酰胺+乙胺丁醇)治疗,研究组在对照组基础上联合利奈唑胺片治疗,比较两组治疗前后脑脊液生化指标[白细胞计数(WBC)、蛋白质、葡萄糖、腺苷脱氨酶(ADA)]水平、神经因子指标[神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)]水平、临床疗效和不良反应发生率。结果:治疗后,两组脑脊液WBC、蛋白质、ADA水平均低于治疗前,且研究组低于对照组,两组脑脊液葡萄糖水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组NGF、NSE水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为95.92%(47/49),高于对照组的79.59%(39/49),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:利奈唑胺联合HRZE方案治疗结核性脑膜脑炎患者可提高治疗总有效率,改善脑脊液生化指标水平,降低神经因子指标水平,其效果优于单纯HRZE方案治疗。

Objective: To observe effects of Linezolid combined with conventional anti-tuberculosis therapy on patients with tuberculous meningitis. Methods: The clinical data of 98 patients with tuberculous meningitis admitted to this hospital from February 2018 to November 2020were retrospectively analyzed. According to different treatment methods, they were divided into study group and control group, 49 cases in each. The control group was given conventional anti-tuberculosis treatment, while the study group was treated with Linezolid tablets on the basis of that of the control group. The levels of cerebrospinal fluid biochemical indexes [white blood cell count(WBC), protein, glucose, adenosine deaminase(ADA)],the nerve factor index levels [nerve growth factor(NGF), neuron specific enolase(NSE)], the total effective rate, and the incidence of adverse reactions were compared between the two groups before and after the treatment. Results: After the treatment, the levels of WBC, protein and ADA in cerebrospinal fluid in the two groups were lower than those before the treatment, and those in the study group were lower than those in the control group;the cerebrospinal fluid glucose levels of the two groups were higher than those before the treatment, and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05). The levels of NGF and NSE in the two groups were lower than those before the treatment, those in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total effective rate of treatment in the study group was 95.92%(47/49), which was higher than 79.59%(39/49) in the control group, and the difference was statistically significant(P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: Linezolid combined with conventional anti-tuberculosis treatment in the patients with tuberculous meningitis can improve the total effective rate of treatment, improve the levels of cerebrospinal fluid biochemical indexes, and reduce the levels of nerve factor indicators.Moreover, it is superior to single conventional anti-tuberculosis treatment.