Tolaj Ilir, Dreshaj Shemsedin, Qehaja Emine, Tolaj Jasmina, Doda-Ejupi Teuta, Mehmeti Murat
Department of Infectious Diseases, University Clinical Center of Kosovo, Prishtina, Kosova.
Med Arh. 2010;64(4):228-30.
With this study we want to evaluate the role of dexamethasone adjuvant treatment in different clinical forms of invasive meningococcal diseases. WORK METHODS: This was a randomized, open label trial that was conducted in 147 individuals with meningococcal sepsis. All of the cases have been divided in two groups: (1) Cases with meningococcal disease and CNS infection, and (2) Cases with meningococcal disease and no affection of the CNS. Cases from both groups were treated with dexamethasone, 0.15 mg/kg, every 6 h, for 4 (four) days, as adjuvant therapy. Cases which were not treated with dexamethasone were used as control group.
From overall number of cases, in 130 of them, the meningococcal disease was accompanied with meningitis; in other 17 cases only signs of sepsis were present. In both clinical forms, the dexamethasone was used in 92 cases. The higher mortality rate is registered among the cases without meningitis, 17.65%, compared with 6.92% which is registered among cases with meningitis. The overall mortality rate among all cases was 8.2%. The significant difference was recorded only on CSF sugar level between two groups (treated or not with dexamethasone) on the day 1-4 of the hospitalization.
Our epidemiological data are in correlation with data from other epidemiological studies. Most of the cases 69.4%, were more than 12 hours sick at home before the hospitalization, 7.5 % of cases were hospitalized within 12 hours from the onset of the diseases, while 23.1% of cases data are missing. This is in correlation with similar data from other studies.
Dexamethasone has a limited effect on outcome of the invasive meningococcal disease. Dexamethasone had some effect only during the days of administration in cases with clinical form of sepsis with meningitis, by normalizing the values of CSF sugar earlier.
通过本研究，我们希望评估地塞米松辅助治疗在不同临床类型的侵袭性脑膜炎球菌病中的作用。
这是一项针对147例脑膜炎球菌败血症患者进行的随机、开放标签试验。所有病例分为两组：（1）患有脑膜炎球菌病且伴有中枢神经系统感染的病例，以及（2）患有脑膜炎球菌病但未累及中枢神经系统的病例。两组病例均接受地塞米松辅助治疗，剂量为0.15mg/kg，每6小时一次，共4天。未接受地塞米松治疗的病例作为对照组。
在所有病例中，130例脑膜炎球菌病伴有脑膜炎；另外17例仅出现败血症体征。在两种临床类型中，92例使用了地塞米松。无脑膜炎病例的死亡率较高，为17.65%，而有脑膜炎病例的死亡率为6.92%。所有病例的总死亡率为8.2%。仅在住院第1 - 4天，两组（接受或未接受地塞米松治疗）的脑脊液糖水平存在显著差异。
我们的流行病学数据与其他流行病学研究的数据相关。大多数病例（69.4%）在住院前在家中患病超过12小时，7.5%的病例在疾病发作后12小时内住院，而23.1%的病例数据缺失。这与其他研究的类似数据相关。
地塞米松对侵袭性脑膜炎球菌病的预后影响有限。地塞米松仅在患有败血症伴脑膜炎临床类型的病例给药期间有一定作用，可使脑脊液糖值更早恢复正常。
