糖皮质激素冲击治疗Ⅲ期结核性脑膜炎疗效观察  

Curative effects observataion of high-dose methylprednisolone on treating advanced tuberculous meningitis

作　　者：王焱烽[1] 陈冰[1] 姚茂元[1] 

机构地区：[1]南京医科大学附属淮安市第一人民医院神经内二科,江苏淮安223300

出　　处：《临床医学》2009年第12期21-22,共2页Clinical Medicine

摘　　要：目的探讨糖皮质激素冲击治疗晚期结核性脑膜炎的有效性和安全性。方法将50例Ⅲ期结核性脑膜炎患者随机分为两组,在抗痨治疗的基础上,治疗组(25例)给予甲基强的松龙500mg/d静脉滴注冲击治疗5d后,迅速减至80mg/d后逐渐减量,对照组(25例)z给予地塞米松15mg/d治疗,症状明显好转后减量,两组激素使用疗程均最多10周。结果治疗组意识障碍恢复时间、体温恢复时间等均优于对照组(P<0.05);疗程12周时的治愈率、好转率及后遗症比较,治疗组均优于对照组(P<0.05),不良反应间差异无统计学意义。结论大剂量甲基强的松龙冲击治疗Ⅲ期结核性脑膜炎疗效显著且不良反应无明显增加。Objective To observe the therapeutic efficacy of high - dose methypredhnisolone on treating advanced tuberculous meningitis. Methods Fifty patients with advanced tuberculous meningitis were randomly divided into two groups, baseing initiate antiphthisie treatment ,treatment group was administered high -dose methyprednisolone （500 mg/d） by intravenous injections for five days ,then was given methyprednisolone with 80 mg/d, and was maintained. Control group was treated with dexamethasone （ 15 mg/d）, then was maintained after improved. Two groups was treated with hormone no more than ten weeks. Results The time of consciousness restoration and the time to defevesence in treatment group decreased significantly （ P 〈 0. 05 ）than control group. These were statistical differences in the cause , efficacy and sequelae between the two groups （ P 〈 0.05 ）. The rate of adverse reactions in the two groups were the same. Conclusion High - dose methylprednisolone are remarkable and safe in the theraply on advanced tuberculous meningitis.

关 键 词：糖皮质激素 冲击治疗 Ⅲ期结核性脑膜炎 

分 类 号：R529.3[医药卫生—内科学] R977.1[医药卫生—临床医学]