结核性脑膜炎治疗新策略的研究进展  

Progress of antitubercular treatment for tuberculous meningitis

作　　者：周晛 孙峰[1] 张文宏[1] Zhou Xian Sun Feng Zhang Wenhong(Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, Chin)

机构地区：[1]复旦大学附属华山医院感染科,上海200040

出　　处：《中华临床感染病杂志》2016年第5期477-480,共4页Chinese Journal of Clinical Infectious Diseases

摘　　要：目前，结核性脑膜炎（Tuberculous meningitis，TBM）仍存在高病死率、高致残率的问题，以肺结核治疗方案为借鉴的传统治疗方案仍不能获得满意的治疗效果。鉴于中枢神经系统感染特殊性，抗结核药物脑脊液药代动力学选择药物是国际上提出 TBM治疗新策略的基础。该文根据最新的循证医学证据，对近年来包括增加利福平剂量、联合喹诺酮类药物和早期加用利奈唑胺等 TBM治疗新方案进行综述。Despite treatment of the same regimens for pulmonary disease,mortality and long-term disability of tuberculous meningitis remain unacceptably high.As the blood-brain barrier limits intracerebral concentration of antimicrobial agents,pharmacokinetics of antitubercular drugs in cerebrospinal fluid has particular relevance for consideration of a novel regimen.Based on the recent evidence,the aim of this article is to review the new strategy of antitubercular treatment for TBM,such as intensified regimen containing rifampicin,adjunctive therapy with fluoroquinolones and short-term linezolid supplementation.

关 键 词：结核 脑膜炎 血脑屏障 药代动力学 利福平 喹诺酮 

分 类 号：R529.3[医药卫生—内科学]