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目的探讨糖皮质激素冲击治疗晚期结核性脑膜炎的有效性和安全性。方法将50例Ⅲ期结核性脑膜炎患者随机分为两组,在抗痨治疗的基础上,治疗组(25例)给予甲基强的松龙500mg/d静脉滴注冲击治疗5d后,迅速减至80mg/d后逐渐减量,对照组(25例)z给予地塞米松15mg/d治疗,症状明显好转后减量,两组激素使用疗程均最多10周。结果治疗组意识障碍恢复时间、体温恢复时间等均优于对照组(P<0.05);疗程12周时的治愈率、好转率及后遗症比较,治疗组均优于对照组(P<0.05),不良反应间差异无统计学意义。结论大剂量甲基强的松龙冲击治疗Ⅲ期结核性脑膜炎疗效显著且不良反应无明显增加。
Objective To investigate the efficacy and safety of glucocorticoid therapy in the treatment of advanced stage tuberculous meningitis. Methods Fifty patients with stage Ⅲ tuberculous meningitis were randomly divided into two groups. On the basis of anti-tuberculosis treatment, the treatment group (25 cases) was given methylprednisolone 500mg / d for 5 days after intravenous infusion. Reduced to 80mg / d gradually reduced, the control group (25 cases) z dexamethasone 15mg / d treatment, the symptoms were significantly improved and then reduced, two groups of hormone treatment are up to 10 weeks. Results The recovery time and recovery time of body temperature in the treatment group were better than those in the control group (P <0.05). The cure rate, improvement rate and sequelae in the treatment group were better than those in the control group (P <0.05) No significant difference between the adverse reactions. Conclusion High doses of methylprednisolone shock treatment of stage Ⅲ tuberculous meningitis significant effect and no significant increase in adverse reactions.