Phuapradit P, Vejjajiva A
Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Q J Med. 1987 Mar;62(239):249-58.
Twenty-eight adult patients admitted consecutively with tuberculous meningitis were treated with pyrazinamide, isoniazid, rifampicin and streptomycin daily during the first two months, followed by isoniazid and rifampicin daily for seven months with intensive management of the complications during the active stage of the meningitis. Twenty-two patients completed the course of treatment and recovered with minimal morbidity in three patients. Two patients died in a vegetative state from other causes seven and nine months after the start of treatment. No evidence of recurrence of meningitis was observed in the 21 patients who were regularly observed for 12 to 29 months after completing treatment. Four patients dropped out during the early stage of treatment. Intensive chemotherapy of tuberculous meningitis with this regimen before the development of serious neurological damage can shorten the duration of treatment to nine months with a favourable outcome.
28例连续收治的结核性脑膜炎成年患者，在前两个月每日接受吡嗪酰胺、异烟肼、利福平及链霉素治疗，随后7个月每日接受异烟肼和利福平治疗，并在脑膜炎活动期对并发症进行强化管理。22例患者完成了治疗疗程，3例患者康复且后遗症轻微。2例患者在治疗开始后7个月和9个月因其他原因处于植物人状态死亡。在完成治疗后接受12至29个月定期观察的21例患者中，未观察到脑膜炎复发迹象。4例患者在治疗早期退出。在严重神经损伤出现之前采用该方案对结核性脑膜炎进行强化化疗，可将治疗时间缩短至9个月，并取得良好疗效。
