DEXAMETHASONE ADJUNCTIVE TREATMENT FOR TUBERCULOUS MENINGITIS
DEXAMETHASONE ADJUNCTIVE TREATMENT FOR TUBERCULOUS MENINGITIS
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DOI：
10.1097/00006454-199103000-00002
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发表时间：
1991-03-01
影响因子：
3.6
通讯作者：
MIKHAIL, IA
中科院分区：
文献类型：
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作者：
GIRGIS, NI;FARID, Z;MIKHAIL, IA
在5年的时间里，2010年在埃及开罗的一家转诊医院的脑膜炎病房收治的280名患者被临床诊断为结核性脑膜炎，并接受抗结核化疗和地塞米松或单独抗结核化疗治疗。在160例脑脊液结核分枝杆菌培养阳性的患者中，比较了两个治疗组的死亡率和神经系统后遗症。51%的总体死亡率反映了接受适当治疗的延迟（79%的症状超过2周）和入院时疾病的严重程度（56%昏迷，39%嗜睡）。地塞米松组病死率明显较低（43% vs. 59%，P < 0.05），尤其是嗜睡患者（15% vs. 40%，P < 0.04），以及存活时间足够长并接受至少10天治疗的患者（14% vs. 33%，P < 0.02）。地塞米松治疗组开始治疗后神经系统并发症（4比10）和永久性后遗症（6比13）的发生率显着降低（P < 0.02）。
During a 5-year period, 280 of 2010 patients admitted to the meningitis ward of a referral hospital in Cairo, Egypt, were clinically diagnosed as having tuberculous meningitis and were treated with either antituberculous chemotherapy and dexamethasone or antituberculous chemotherapy alone. Fatality rates and neurologic sequelae were compared for the 2 treatment groups in the 160 patients who had cerebrospinal fluid cultures positive for Mycobacterium tuberculosis. The overall mortality rate of 51% reflects the delay in receiving appropriate therapy (79% with symptoms for more than 2 weeks) and the severity of illness on admission (56% in coma, 39% drowsy). The fatality rate was significantly lower in the group receiving dexamethasone (43% vs. 59%, P < 0.05), particularly in the drowsy patients (15% vs. 40% P < 0.04), and in patients surviving long enough to receive at least 10 days of treatment (14% vs. 33%, P < 0.02). Development of neurologic complications after initiation of therapy (4 vs. 10) and permanent sequelae (6 vs. 13) were significantly lower in the dexamethasone-treated group (P < 0.02).