Bhaumik S, Behari M
Department of Neurology, All Institute of Medical Sciences, New Delhi - 110 029, India.
Neurol India. 1998 Jul-Sep;46(3):225-228.
Thirty patients of bacterial meningitis (age> 12 years) were randomised into two treatment groups. Group I (n=14) received intravenous dexamethasone with antibiotics and group II (n=16)received only antibiotics. Baseline demographic, clinical and laboratory features of the two groups were similar. Four patients died, three in control group and one in dexamethasone group (p=0.60). Focal neurological deficits at discharge were found in three patients receiving dexamethasone and two in control group (p=0.64). Audiological sequelae were found in seven (23) patients, four in group I and three in group II (p = 1.00) but there were no statistically significant differences between the two groups. No steroid side effects were noted. In the present study, dexamethasone treatment was not found to significantly improve survival but sample size was too small to reliably exclude clinically important benefit of dexamethasone. Larger randomised controlled studies in adult population are needed to reliably estimate the effects of dexamethasone as adjunctive therapy in acute bacterial meningitis in adults.
30例细菌性脑膜炎患者（年龄>12岁）被随机分为两个治疗组。第一组（n=14）接受静脉注射地塞米松联合抗生素治疗，第二组（n=16）仅接受抗生素治疗。两组的基线人口统计学、临床和实验室特征相似。4例患者死亡，3例在对照组，1例在地塞米松组（p=0.60）。出院时，接受地塞米松治疗的3例患者和对照组的2例患者出现局灶性神经功能缺损（p=0.64）。7例（23%）患者出现听力后遗症，第一组4例，第二组3例（p = 1.00），但两组之间无统计学显著差异。未观察到类固醇副作用。在本研究中，未发现地塞米松治疗能显著提高生存率，但样本量过小，无法可靠地排除地塞米松的临床重要益处。需要在成年人群中进行更大规模的随机对照研究，以可靠地评估地塞米松作为成人急性细菌性脑膜炎辅助治疗的效果。
