The Efficacy of Intrathecal Injection of Different Doses of Isoniazid Combined with Dexamethasone in the Treatment of Tuberculous Meningitis
Objective To compare the efficacy of intrathecal injection of different doses of isoniazid combined with dexamethasone in the treatment of tuberculous meningitis(TBM).Methods Sixty TBM patients from Zhumadian Central Hospital from January 2019 to December 2022 were selected and randomly divided into a low-dose group and a high-dose group using a random number table method,with 30 patients in each group.Both groups of patients were given routine anti-tuberculosis treatment.The low-dose group received intrathecal injection of 100 mg isoniazid combined with 5 mg dexamethasone,while the high-dose group received intrathecal injection of 200 mg isoniazid combined with 5 mg dexamethasone,both of which continued for 3 months.The clinical efficacy,cerebrospinal fluid indexes(cell count,protein,chloride,glucose)and inflammation levels[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]were compared between the two groups,and the incidence of adverse reactions during treatment was counted.Results The total clinical efficacy rate of the high-dose group was higher than that of the low-dose group(P＜0.05).At 3 months of treatment,the cerebrospinal fluid cell count and protein levels in the high-dose group were lower than those in the low-dose group,while chloride and glucose levels were higher than those in the low-dose group(P＜0.05).After 3 months of treatment,the levels of serum IL-8 and TNF-α in the high-dose group were lower than those in the low-dose group(P＜0.05).The incidence of adverse effects during the treatment period showed no significant difference(P＞0.05).Conclusion The treatment of TBM patients with intrathecal injection of high-dose isoniazid combined with dexamethasone can improve efficacy,improve cerebrospinal fluid indicators and inflammation levels,and do not increase adverse reactions.
NETL
NSTL
万方数据
