Schoeman Johan F, Janse van Rensburg Anita, Laubscher Jacoba A, Springer Priscilla
Department of Pediatrics and Child Health, Tygerberg Children's Hospital Faculty of Health Sciences, Stellenbosch University, South Africa.
J Child Neurol. 2011 Aug;26(8):956-62. doi: 10.1177/0883073811398132. Epub 2011 May 31.
Arterial stroke is the main cause of poor outcome in childhood tuberculous meningitis. Aspirin has an antithrombotic action at low dose and anti-ischemic and anti-inflammatory properties, which are dose-related. The aim of the study was to explore the possible benefits of aspirin in children with tuberculous meningitis. A total of 146 consecutive children with a diagnosis of probable tuberculous meningitis were studied. Patients were randomized into 3 groups: (1) placebo group, (2) low-dose aspirin group, and (3) high-dose aspirin group. Twenty-nine additional patients who received aspirin before admission were excluded from the randomized study, but continued on low-dose aspirin. Aspirin, irrespective of dose, did not show any significant benefit regarding morbidity (hemiparesis and developmental outcome) and mortality. Aspirin was well tolerated, but 1 death was probably related to aspirin. The fact that the outcome of the high-dose aspirin group compared favorably with the other treatment groups despite younger age and more severe neurological involvement at baseline needs further investigation.
动脉性卒中是儿童结核性脑膜炎预后不良的主要原因。阿司匹林在低剂量时具有抗血栓作用以及抗缺血和抗炎特性，且这些特性与剂量相关。本研究的目的是探讨阿司匹林对结核性脑膜炎患儿可能带来的益处。共对146例连续诊断为疑似结核性脑膜炎的儿童进行了研究。患者被随机分为3组：（1）安慰剂组，（2）低剂量阿司匹林组，（3）高剂量阿司匹林组。另外29例入院前接受过阿司匹林治疗的患者被排除在随机研究之外，但继续服用低剂量阿司匹林。无论剂量如何，阿司匹林在发病率（偏瘫和发育结局）和死亡率方面均未显示出任何显著益处。阿司匹林耐受性良好，但有1例死亡可能与阿司匹林有关。尽管高剂量阿司匹林组患儿基线时年龄更小且神经受累更严重，但其结局与其他治疗组相比更有利，这一事实需要进一步研究。
