利奈唑胺联合HRZE抗结核方案治疗重症结核性脑膜炎患者的效果  

Effects of Linezolid combined with HRZE antituberculosis regimen in treatment of patients with severe tuberculous meningitis

作　　者：尚勇 沈伊鹤 张清艳 陈琳洁 SHANG Yong;SHEN Yihe;ZHANG Qingyan;CHEN Linjie(Pharmacy Department of Staff Hospital of Pingdingshan Coal(Group)No.12 Mine,Pingdingshan 467000 Henan,China)

机构地区：[1]平顶山煤业(集团)十二矿职工医院药剂科,河南平顶山467000

出　　处：《中国民康医学》2022年第14期24-26,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察利奈唑胺联合HRZE抗结核方案治疗重症结核性脑膜炎(TBM)患者的效果。方法:选取2018年2月至2021年2月该院收治的68例重症TBM患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各34例。两组均给予常规对症治疗,在此基础上,对照组给予HRZE抗结核方案(异烟肼+利福平+吡嗪酰胺+乙胺丁醇)治疗,观察组在对照组基础上联合利奈唑胺片治疗,比较两组疗效、格拉斯哥昏迷评分(GCS评分)、脑脊液生化指标(氯化物、葡萄糖、蛋白质、白细胞计数)水平、脑脊液神经元特异性烯醇化酶(NSE)水平、脑脊液C反应蛋白(CRP)水平和脑脊液神经生长因子(NGF)水平。结果:观察组治疗总有效率为94.12%,明显高于对照组的73.53%,差异有统计学意义(P<0.05);治疗后,两组GCS评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组脑脊液氯化物和葡萄糖水平均高于治疗前,且观察组高于对照组,两组脑脊液白细胞计数和蛋白质水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组脑脊液NSE、CRP和NGF水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:利奈唑胺联合HRZE抗结核方案治疗重症TBM患者可提高治疗总有效率和GCS评分,改善脑脊液生化指标水平,以及降低脑脊液NSE、CRP和NGF水平,效果优于单纯HRZE抗结核方案治疗。Objective:To observe effects of Linezolid combined with HRZE antituberculosis regimen in treatment of patients with severe tuberculous meningitis(TBM).Methods:68 severe TBM patients admitted to our hospital from February 2018 to February 2021 were selected for the prospective study and were divided into observation group and control group according to the random number table method,34 cases in each.Both groups were given routine symptomatic treatment.On this basis,the control group was treated with HRZE antituberculosis regimen(Isoniazid+Rifampicin+Pyrazinamide+Ethambutol),while the observation group was treated with Linezolid tablets on the basis of that of the control group.The curative effects,the Glasgow coma score(GCS score),the cerebrospinal fluid biochemical index levels(chloride,glucose,protein,white blood cell count),the neuron-specific enolase(NSE)level in the cerebrospinal fluid,the C-reactive protein(CRP)level in the cerebrospinal fluid and the nerve growth factor(NGF)level in the cerebrospinal fluid were compared between the two groups.Results:The total effective rate of the observation group was 94.12%,which was significantly higher than the control group of 73.53%,and the difference was statistically significant(P<0.05).After the treatment,the GCS scores of the two groups were higher than those before the treatment,that of the observation group was higher than that of the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of cerebrospinal fluid chloride and glucose in the two groups were higher than those before the treatment,and those of the observation group were higher than those of the control group;the cerebrospinal fluid white blood cell count and the protein levels in the two groups were lower than those before the treatment,and those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).Further,after the treatment,the levels of NSE,CRP and NGF in the cerebrospinal fl

关 键 词：重症结核性脑膜炎 利奈唑胺 HRZE方案 脑脊液 格拉斯哥昏迷评分 

分 类 号：R529.3[医药卫生—内科学]