Evans D J
Hemel Hempstead Hospital, Hillfield Road, Hemel Hempstead, Herts, HP2 4AD, UK.
Respir Med. 2008 Jun;102(6):793-800. doi: 10.1016/j.rmed.2008.01.018. Epub 2008 Apr 14.
Tuberculosis remains a major cause of mortality and morbidity on a global scale. Effective anti-tuberculous chemotherapy has improved outcomes for individuals suffering from tuberculosis, although the disease often results in significant and permanent damage to organs. The use of adjunctive corticosteroid treatment has been studied with a view to demonstrating a reduction in inflammatory events that may improve outcomes for both mortality and morbidity. Cochrane reviews have summarized the evidence for adjunctive corticosteroids in the treatment of tuberculous pericarditis, meningitis and pleural effusion. These reviews have shown improved mortality for pericarditis and meningitis, but inconclusive effects for pericardial constriction and ongoing neurological disability. Rapid improvements in clinical parameters for pleural effusion were not supported by any lasting improved outcomes for these patients.
在全球范围内，结核病仍然是导致死亡和发病的主要原因。有效的抗结核化疗改善了结核病患者的治疗效果，尽管该疾病常常会对器官造成严重且永久性的损害。人们对辅助性皮质类固醇治疗进行了研究，以期证明其能减少炎症反应，从而可能改善死亡率和发病率。Cochrane系统评价总结了辅助性皮质类固醇治疗结核性心包炎、脑膜炎和胸腔积液的证据。这些评价表明，皮质类固醇治疗可改善心包炎和脑膜炎的死亡率，但对于心包缩窄和持续性神经功能障碍的影响尚无定论。胸腔积液患者临床参数的快速改善并未带来任何持久的良好预后。
