利奈唑胺联合左氧氟沙星在结核性脑膜炎抗结核强化期治疗中的应用效果观察

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目的:探讨利奈唑胺(LZD)联合左氧氟沙星(LFX)在结核性脑膜炎患者抗结核强化期治疗中的临床效果。方法:选取太原市第四人民医院2015年5月至2018年4月收治的结核性脑膜炎抗结核强化期患者76例为观察对象,根据治疗方案不同分为对照组38例、观察组38例,对照组予以常规疗法(异烟肼+利福平+吡嗪酰胺+乙胺丁醇),观察组在常规疗法基础上联合LZD和LFX治疗,两组疗程均为8周,比较两组临床疗效。结果:观察组总有效率为92.11%(35/38)、并发症发生率为5.26%(2/38),对照组分别为68.42%(26/38)、23.68%(9/38),两组差异均有统计学意义(χn 2=6.727、5.028,均n P<0.05);治疗后,观察组脑脊液白细胞计数、葡萄糖、蛋白质分别为(30.21±4.16)×10n 6/L、(3.65±0.32)mmol/L、(0.79±0.15)g/L,对照组分别为(54.28±6.42)×10n 6/L、(2.18±0.21)mmol/L、(0.98±0.21)g/L,两组差异均有统计学意义(n t=19.396、23.675、4.538,均n P<0.001);对照组、观察组患者生活质量评分分别为(187.59±4.11)分、(216.94±3.90)分,两组差异有统计学意义(n t=31.933,n P<0.001)。n 结论:LZD联合LFX在结核性脑膜炎患者抗结核强化期治疗中的疗效明显优于常规治疗,安全性高。“,”Objective:To investigate the clinical effect of linezolid combined with levofloxacin in the intensive treatment of tuberculous meningitis.Methods:Seventy-six patients with tuberculous meningitis who underwent intensive treatment from May 2015 to April 2018 in the Fourth People's Hospital of Taiyuan were included in this study. They were assigned to a control group (n n = 38) and an observation group (n n = 38) according to treatment methods. The control group was given conventional treatment (isoniazid + rifampicin + pyrazinamide + ethambutol). The observation group was given treatment with linezolid combined with levofloxacin based on conventional treatment. All patients were treated for 8 successive weeks. Clinical efficacy was compared between the two groups.n Results:Total effective rate and the incidence of complications were 92.11% (35/38) and 5.26% (2/38) respectively in the observation group, and they were 68.42% (26/38) and 23.68% (9/38) respectively in the control group. There were significant differences in total effective rate and the incidence of complications between the two groups (n χ2 = 6.727 and 5.028, both n P < 0.05). After treatment, white blood cell count, blood glucose level, and protein level were (30.21 ± 4.16) × 10 n 6/L, (3.65 ± 0.32) mmol/L and (0.79 ± 0.05) g/L, respectively in the observation group, while they were (54.28 ± 6.42) × 10n 6/L, (2.18 ± 0.21) mmol/L, (0.98 ± 0.21) g/L, respectively in the control group. There were significant differences in white blood cell count, blood glucose level and protein level between the two groups (n t = 19.396, 23.675, 4.538, all n P < 0.05). There was significant difference in the score of quality of life between the control and observation groups [(187.59 ± 4.11) points n vs. (216.94 ± 3.90) points, n t = 31.933, n P < 0.05].n Conclusion:Linezolid combined with levofloxacin based on conventional treatment exhibits better clinical efficacy with high safety in the intensive treatment of tuberculous meningitis than conventional treatment.
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