The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis
The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis
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DOI：
10.1080/07430170120093481
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发表时间：
2001-12-01
影响因子：
--
通讯作者：
Donald, PR
中科院分区：
文献类型：
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作者：
Schoeman, JF;Elshof, JWM;Donald, PR
最近的三项研究发现，皮质类固醇可改善结核性脑膜炎（TBM）的临床结局和死亡率，尽管该药物的确切作用机制仍处于推测状态。已经发表了一些关于皮质类固醇对TBM中脑脊液（CSF）结果影响的报告，通常在连续细胞计数和蛋白水平方面存在相互矛盾的结果。作为我们机构关于口服泼尼松对儿童TBM结局影响的对照、随机试验的一部分，在治疗的第一个月期间每周收集并分析CSF。我们发现在研究中类固醇和非类固醇组之间的连续CSF细胞计数没有显著差异。然而，类固醇组在治疗第1个月后CSF蛋白和球蛋白水平显著较低，CSF葡萄糖水平较非类固醇组稳定升高。了解抗结核治疗过程中不同CSF反应对临床决策的重要性。
Three recent studies found that corticosteroids improve clinical outcome and mortality in tuberculous meningitis (TBM), although the exact mechanism of action of the drug remains speculative. A number of reports on the effect of corticosteroids on cerebrospinal fluid (CSF) findings in TBM have been published, often with conflicting results regarding serial cell counts and protein levels. As part of a controlled, randomized trial on the effect of oral prednisone on outcome in childhood TBM at our institution, CSF was collected and analysed weekly during the 1st month of treatment. We found no significant difference in serial CSF cell counts between the steroid and non-steroid groups in the study. However, the steroid group had significantly lower CSF protein and globulin levels after the 1st month of treatment, and a more steady rise in CSF glucose levels than the non-steroid group. Knowledge of the different CSF responses during the course of anti-tuberculosis therapy is important in clinical decisionmaking.