结核性脑膜炎(下称结脑)通过化疗后,治愈率虽已明显地提高,然而近年来由于结脑发病率的下降,有些儿科医生在诊断上常发生延误。为了减少死亡率,预防后遗症,需要立即予以适当的药物治疗。在试图选用一种化疗方案时,仍然主要依靠药物的药理特性,包括杀菌效力与抑菌效力对比、脑脊液内药物浓度、药物毒性及其相互之间的作用。此外,要选择多种药物联合治疗,以防止抗药菌株出现。目前常用的治疗方案,包含了异菸肼、链霉素、PAS三种第一线抗结核药物。鉴于在医院内对异菸肼和链霉素耐药菌株发生率增加,Steiner等把利福平扩充到化疗范围之内,其他作者同样建议利福平可与异菸肼一道,作为结脑治疗的第一线药物。 Tuberculosis meningitis (hereinafter referred to as knot brain) through chemotherapy, although the cure rate has been significantly improved, but in recent years due to the decline in the incidence of tuberculosis, some pediatricians often delay in diagnosis. In order to reduce mortality and prevent sequelae, appropriate medical treatment needs to be given immediately. In trying to choose a chemotherapy regimen, still rely mainly on the pharmacological properties of drugs, including the efficacy of bactericidal and bacteriostatic efficacy, drug concentration in cerebrospinal fluid, drug toxicity and their interaction with each other. In addition, multiple drug combinations should be selected to prevent emergence of drug-resistant strains. Currently used treatment options, including isoniazid, streptomycin, PAS three first-line anti-TB drugs. Given the increased incidence of isoniazid and streptomycin resistant strains in hospitals, Steiner et al. Extended rifampicin to chemotherapy, and other authors also suggested that rifampicin may be used in combination with isoniazid as a treatment for tuberculous meningitis The first line of drugs.