结核性脑膜炎治疗研究进展  

Research progress in treatment of tuberculous meningitis

作　　者：王乐乐 郭建琼 李俊刚 杨松[1] 唐神结[3] Wang Lele;Guo Jianqiong;Li Jungang;Yang Song;Tang Shenjie(Tuberculosis Research Laboratory,Chongqing Public Health Medical Center,Chongqing 400036,China;Department of Infectious Diseases,The Southwest Hospital of Army Medical University,Chongqing 400032,China;Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Research Institute,Beijing 101149,China)

机构地区：[1]重庆市公共卫生医疗救治中心结核病研究室,400036 [2]陆军军医大学第一附属医院感染科,重庆400032 [3]首都医科大学附属北京胸科医院北京市结核病胸部肿瘤研究所,101149

出　　处：《中华临床感染病杂志》2021年第5期392-398,共7页Chinese Journal of Clinical Infectious Diseases

基　　金：重庆市卫生健康委员会、重庆市科学技术局联合医学科研计划(2018MXSM013,2019ZDXM035)。

摘　　要：结核性脑膜炎(Tuberculous meningitis,TBM)是中枢神经系统(Central nervous system,CNS)结核最常见和最严重的一种类型,致死率和致残率高,引起全球公共卫生的广泛关注。高致死率和致残率可能与缺乏特异的TBM临床和影像学特点、临床医师重视不够、早期敏感而特异的诊断检测技术缺乏、治疗延误、抗结核药物穿透进入血脑屏障不同程度受限或/和耐多药结核病等因素有关。为加强对TBM的重视程度,提高治愈率,降低病死率和致残率,以及提高TBM患者的生活质量,本文就TBM的危害、化疗药物、化疗方案、抗炎剂、阿司匹林、介入和外科手术治疗等治疗方面进行综述,供临床参考。Tuberculous meningitis is the most common and serious type of central nervous system tuberculosis,with high mortality and disability rate,which has attracted extensive attention of global public health.The high mortality rate and disability rate of tuberculosis meningitis may be related to its lack of specific clinical and imaging characteristics,insufficient attention from clinicians,lack of early sensitive and specific diagnostic testing techniques,delay in treatment,and restricted penetration of anti-TB drugs into the blood-brain barrier or/and MDR-TB,etc.This article reviews the disease burden of TBM,chemotherapy drugs and regimens,anti-inflammatory agents,aspirin,interventional and surgical treatment to provide reference for clinical management of this disease.

关 键 词：结核 脑膜 化疗药物 抗炎剂 介入治疗 外科手术治疗 

分 类 号：R529.3[医药卫生—内科学]