利奈唑胺联合莫西沙星与HRZE方案治疗结核性脑膜炎的临床效果

Efficacy of linezolid combined with moxifloxacin and HRZE scheme in the treatment of tuberculous meningitis

目的 探讨利奈唑胺联合莫西沙星与HRZE方案治疗结核性脑膜炎的临床效果。方法 回顾性选取2020年6月—2022年7月赣州市第五人民医院收治的结核性脑膜炎患者70例作为研究对象,按照治疗方法分为对照组和研究组,各35例。患者均采用常规治疗及HRZE方案,对照组在此基础上采用莫西沙星治疗,研究组则在对照组基础上予以利奈唑胺,2组均治疗4个月。比较2组临床疗效,治疗前及治疗4个月后生化指标(腺苷脱氨酶、血清总蛋白、葡萄糖、白细胞计数)、脑脊液压力及不良反应发生情况。结果 研究组总有效率高于对照组(94.29%vs. 71.43%,χ^(2)=6.437,P=0.011)。治疗4个月后,2组腺苷脱氨酶、血清总蛋白、白细胞计数低于治疗前,葡萄糖高于治疗前,且研究组变化幅度大于对照组(P<0.05或P<0.01)。治疗4个月后,2组脑脊液压力低于治疗前,且研究组低于对照组(P<0.01)。对照组与研究组不良反应总发生率比较,差异无统计学意义(14.29%vs. 20.00%,χ^(2)=0.402,P=0.526)。结论 利奈唑胺联合莫西沙星与HRZE方案治疗结核性脑膜炎可增强疗效,有效降低脑脊液压力,改善生化指标,且用药安全性较高。

Objective To investigate the effect of linezolid combined with moxifloxacin and HRZE scheme in the treatment of tuberculous meningitis.Methods A total of 70 patients with tuberculous meningitis admitted to the Fifth People′s Hospital of Ganzhou from June 2020 to July 2022 were selected retrospectively,and they were divided into the control group and the study group,35 cases in each group.Patients were received routine treatment and HRZE scheme treatment,based on this,the control group was plus moxifloxacin,while the study group received linezolid on the basis of the control group.Both groups were treated for 4 months.Clinical effect,biochemical indexes(adenosine deaminase,total protein,glucose,white blood cell count),cerebrospinal fluid pressure before and after 4 months of treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(94.29%vs.71.43%,χ^(2)=6.437,P=0.011).After 4 months of treatment,adenosine deaminase,total protein,white blood cell count of the two groups were lower than those before treatment,glucose was higher than that before treatment,and the amplitude of variation of the study group was greater than that of the control group(P<0.05 or P<0.01).After 4 months of treatment,cerebrospinal fluid pressure of the two groups was lower than that before treatment,and the study group was lower than control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the control group and the study group(14.29%vs.20.00%,χ^(2)=0.402,P=0.526).Conclusion Linezolid combined with moxifloxacin and HRZE scheme have significant effect in the treatment of tuberculous meningitis,which can effectively reduce cerebrospinal fluid pressure,improve biochemical indexes,and with higher safety.