糖皮质激素联合四联抗结核药物治疗老年结核性脑膜炎的效果及对脑脊液细胞学的影响分析
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摘要
目的:研究分析糖皮质激素联合四联抗结核药物治疗老年结核性脑膜炎(tuberculous meningitis,TBM)的效果与对脑脊液(CSF)细胞学的影响。方法:选择笔者所在医院2016年7月-2018年7月收治的60例老年TBM患者为本次观察对象,应用数字随机法将其分为对照组(n=30)与研究组(n=30),其中对照组患者单纯给予四联抗结核药物进行治疗,研究组则在对照组基础上联合糖皮质激素治疗,对比观察两组患者经不同方式治疗后的临床效果、不良症状改善情况及对CSF细胞学指标的影响。结果:治疗后,研究组临床效果显著优于对照组(P<0.05)。研究组患者意识恢复时间、退热时间均明显短于对照组(P<0.05)。治疗后,研究组患者CSF细胞学指标中白细胞数(WBC)、蛋白质(Pro)均低于治疗前,氯化钠(NaCl)、葡萄糖含量均高于治疗前,研究组各项指标水平变化均优于对照组,差异均有统计学意义(P<0.05)。结论:对老年TBM患者在临床中采用糖皮质激素联合四联抗结核药物治疗,对于进一步提高临床治疗效果,促进患者恢复,改善其炎性状态有着积极作用,值得在临床中应用。
Objective:To study and analyze the clinical effect of Glucocorticoid combined with quadruple anti-tuberculosis drugs in treatment of elderly patients with tuberculous meningitis(TBM) and its influence of cerebrospinal fluid(CSF).Method:A total of 60 cases of elderly patients with TBM and who treated in the hospital from July 2016 to July 2018 were selected as the observation objects,and the patients were divided into the control group(n=30) and the study group(n=30) by digital random method.The control group of patients were treated with quadruple antituberculosis drugs only,while the study group were treated with Glucocorticoid on the basis of the control group.Then,the clinical effect,adverse symptoms improved and the influence of CSF cytology indicators after different treatment were compared between the two groups.Result:After treatment,the clinical effect of the study group was significantly better than that in the control group(P<0.05).The recovery time of consciousness and antipyretic time of the patients in the study group were significantly shorter than those in the control group(P<0.05).And after treatment,the CSF cytological indexes such as white blood cell(WBC) and protein(Pro) in the study group were lower than those before treatment,and the contents of sodium chloride(NaCl) and glucose were higher than those before treatment.Compared with the control group,all the indexes in the study group were better than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of Glucocorticoid combined with quadruple anti-tuberculosis drugs in treatment of elderly patients with TBM,which plays an active role in further improving the clinical treatment effect,promoting the recovery of patients and improving their inflammatory state,thus it is worth applying in the clinical.
Objective:To study and analyze the clinical effect of Glucocorticoid combined with quadruple anti-tuberculosis drugs in treatment of elderly patients with tuberculous meningitis(TBM) and its influence of cerebrospinal fluid(CSF).Method:A total of 60 cases of elderly patients with TBM and who treated in the hospital from July 2016 to July 2018 were selected as the observation objects,and the patients were divided into the control group(n=30) and the study group(n=30) by digital random method.The control group of patients were treated with quadruple antituberculosis drugs only,while the study group were treated with Glucocorticoid on the basis of the control group.Then,the clinical effect,adverse symptoms improved and the influence of CSF cytology indicators after different treatment were compared between the two groups.Result:After treatment,the clinical effect of the study group was significantly better than that in the control group(P<0.05).The recovery time of consciousness and antipyretic time of the patients in the study group were significantly shorter than those in the control group(P<0.05).And after treatment,the CSF cytological indexes such as white blood cell(WBC) and protein(Pro) in the study group were lower than those before treatment,and the contents of sodium chloride(NaCl) and glucose were higher than those before treatment.Compared with the control group,all the indexes in the study group were better than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of Glucocorticoid combined with quadruple anti-tuberculosis drugs in treatment of elderly patients with TBM,which plays an active role in further improving the clinical treatment effect,promoting the recovery of patients and improving their inflammatory state,thus it is worth applying in the clinical.
引文
[1]朱烽烽,沈兴华.利奈唑胺治疗危重结核性脑膜炎的效果分析及对患者脑脊液神经生长因子及其受体的影响研究[J].临床和实验医学杂志,2018,17(5):503-506.
[2]张龙久.醒脑静注射液联合抗结核治疗结核性脑膜炎疗效观察[J].现代中西医结合杂志,2017,26(30):60-62.
[3]岳玉瑛.高压氧联合脑脊液置换加鞘内注药治疗结核性脑膜炎的疗效观察[J].中西医结合心脑血管病杂志,2017,15(4):492-493.
[4]李倩,张建树,孟艺哲.地塞米松联合异烟肼鞘内注射治疗结核性脑膜炎效果观察[J].解放军医药杂志,2017,29(11):80-83.
[5]胡清亮,张绿浪.四联抗结核药物联合利奈唑胺、莫西沙星对难治性结核性脑膜炎患者CSF细胞学、NSE和NGF及其受体的影响[J].海南医学院学报,2018,24(15):1422-1425,1430.
[6]张晓东,李晶超.糖皮质激素联合四联抗结核药物治疗老年结核性脑膜炎的疗效及对脑脊液细胞学的影响[J].中国老年学杂志,2017,37(4):949-951.
[7]龙云升,黄志泳.脑脊液置换联合鞘内注药治疗结核性脑膜炎的效果分析[J].中国当代医药,2016,23(19):33-35.
[8]宋春华,于长国,车海涌,等.改良腰大池置管术及不同椎管给药次数治疗结核性脑膜炎的疗效观察[J].中国防痨杂志,2016,38(7):592-596.
[9]刘春燕,仵倩红,杜鹃.莫西沙星或左氧氟沙星联合抗结核药物治疗难治性结核性脑膜炎疗效及安全性对比[J].现代生物医学进展,2016,16(34):6717-6720.
[10]王芙蓉.莫西沙星联合抗结核药物治疗难治性结核性脑膜炎临床疗效观察[J].中国实用医药,2016,11(27):169-170.
[11]李建辉.糖皮质激素治疗结核性脑膜炎的临床疗效[J].中国实用神经疾病杂志,2016,19(16):10-12.
[12]徐齐峰,宋晓东,孟婵.糖皮质激素辅助治疗成人结核性脑膜炎的疗效[J].包头医学院学报,2016,32(8):29-30.
[2]张龙久.醒脑静注射液联合抗结核治疗结核性脑膜炎疗效观察[J].现代中西医结合杂志,2017,26(30):60-62.
[3]岳玉瑛.高压氧联合脑脊液置换加鞘内注药治疗结核性脑膜炎的疗效观察[J].中西医结合心脑血管病杂志,2017,15(4):492-493.
[4]李倩,张建树,孟艺哲.地塞米松联合异烟肼鞘内注射治疗结核性脑膜炎效果观察[J].解放军医药杂志,2017,29(11):80-83.
[5]胡清亮,张绿浪.四联抗结核药物联合利奈唑胺、莫西沙星对难治性结核性脑膜炎患者CSF细胞学、NSE和NGF及其受体的影响[J].海南医学院学报,2018,24(15):1422-1425,1430.
[6]张晓东,李晶超.糖皮质激素联合四联抗结核药物治疗老年结核性脑膜炎的疗效及对脑脊液细胞学的影响[J].中国老年学杂志,2017,37(4):949-951.
[7]龙云升,黄志泳.脑脊液置换联合鞘内注药治疗结核性脑膜炎的效果分析[J].中国当代医药,2016,23(19):33-35.
[8]宋春华,于长国,车海涌,等.改良腰大池置管术及不同椎管给药次数治疗结核性脑膜炎的疗效观察[J].中国防痨杂志,2016,38(7):592-596.
[9]刘春燕,仵倩红,杜鹃.莫西沙星或左氧氟沙星联合抗结核药物治疗难治性结核性脑膜炎疗效及安全性对比[J].现代生物医学进展,2016,16(34):6717-6720.
[10]王芙蓉.莫西沙星联合抗结核药物治疗难治性结核性脑膜炎临床疗效观察[J].中国实用医药,2016,11(27):169-170.
[11]李建辉.糖皮质激素治疗结核性脑膜炎的临床疗效[J].中国实用神经疾病杂志,2016,19(16):10-12.
[12]徐齐峰,宋晓东,孟婵.糖皮质激素辅助治疗成人结核性脑膜炎的疗效[J].包头医学院学报,2016,32(8):29-30.