The clinical efficacy of anti-tuberculosis combined、with high-dose methylprednisolone in treatment of advanced tuberculous meningitis
10.3760/cma.j.issn.1008-6706.2011.11.010
- VernacularTitle:抗结核药联合大剂量糖皮质激素冲击治疗晚期结核性脑膜炎临床观察
- Author:
Ting LI
- Publication Type:Journal Article
- Keywords:
Meningoencephalitis;
Glucocorticoids;
Shock treatment
- From:
Chinese Journal of Primary Medicine and Pharmacy
2011;18(11):1460-1461
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical efficacy and security of anti-tuberculosis combined with highdose methylprednisolone in treatment of advanced tuberculous meningitis.Methods 77 patients with advanced tuberculous meningitis in our department were randomly divided into the observation group(39 cases)and the control group (38 cases).All of the patients were given initiate antiphthisie treatment,the control group were added dexamethasone,20mg/d,iv drip,then was maintained after improved;the observation group were added high-dose methyprednisolone(500mg/d)by intravenous injection for five days,then was given methyprednisolone 80mg/d to maintain.Two groups were treated with hormone no more than three months.Then the clinical efficacy and adveme reaction were compared.Results The observation group:32 cases of healing,6 cases of effective,1 case of inefficient,the total effective rate was 97.4%and the control group were 22,8,8,78.9%;the difference of total effective rates in the two groups was statistically significant(x2=7.57,P＜0.05).The time of consciousness restoration and defevesence,the white blood cell count,protein chloride and glucose content of cerebrospinal fluid of the observation group were(2.7±1.3)d,(13±5)d,(112.37±27.57)×106/L,(3.04±0.82)g/L,(32.7±6.4)mmol/L and(1.67±0.65)mmol/L;and the control group were(5.2±2.4)d,(19±6)d,(93.74±20.18)×106/L,(1.92±0.64)g/L,(25.4 ±5.2)mmol/L and(1.04±0.34)mmol/L,the difference was statistically significant(t=5.70,4.77,3.88,6.67,5.48,5.31,P＜0.01);The difference of adverse reaction rate between the two groups was not statistically significant (P＜0.05).Conclusion The clinical efficacy of anti-tuberculosis combined with high-dose methylprednisolone in treatment of advanced tuberculous meningitis was better and had advantages in improving symptoms and signs without enhancing the rate of adverse reaction and it was worth to promote in clinical.
