Quagliarello V, Scheld W M
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510.
Infect Agents Dis. 1992 Jun;1(3):167-71.
Bacterial meningitis continues to cause morbidity and mortality despite bactericidal antibiotic therapy. Experimental studies of pathophysiology reveal the bacteria and their surface components within cerebrospinal fluid (CSF) induce the release of inflammatory cytokines that promote CSF inflammation, injure the cerebral microvasculature and cause brain edema. Adjunctive corticosteroids reduce inflammation, ameliorate the pathophysiology, and improve neurologic outcome in children. Practical recommendations are made for children and selected adults regarding current and future directions of adjunctive therapy.
尽管使用了杀菌性抗生素治疗，但细菌性脑膜炎仍会导致发病和死亡。病理生理学的实验研究表明，脑脊液（CSF）中的细菌及其表面成分会诱导炎性细胞因子的释放，这些因子会促进脑脊液炎症，损伤脑微血管并导致脑水肿。辅助使用皮质类固醇可减轻炎症，改善病理生理状况，并改善儿童的神经学预后。针对儿童和部分成人，就辅助治疗的当前和未来方向给出了实用建议。
