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目的:探讨莫西沙星或左氧氟沙星联合抗结核药物治疗难治性结核性脑膜炎的疗效及安全性。方法:收取2011年12月至2014年12月我院收治的难治性结核性脑膜炎患者68例作为研究对象,随机分为观察组及对照组各34例,分别采用莫西沙星或左氧氟沙星联合抗结核药物进行治疗。对两组患者临床疗效、脑脊液相关指标、生活质量评分以及不良反应发生情况进行观察与对比。结果:治疗后两组患者脑脊液压力、蛋白质含量及白细胞数量均明显降低,葡萄糖含量明显升高,差异均有统计学意义(P<0.05);观察组变化幅度明显强于对照组(P<0.05)。观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组患者在PF、RP、BP、GH及VT等维度得分均显著高于对照组,差异有统计学意义(P<0.05);两组患者在SF、RE及MH等维度得分无显著差异(P>0.05)。两组患者不良反应发生率无显著差异(P>0.05)。结论:莫西沙星联合抗结核药物治疗难治性结核性脑膜炎疗效优于左氧氟沙星,安全性高,值得临床推广应用。
Objective: To investigate the efficacy and safety of moxifloxacin or levofloxacin combined with anti-TB drugs in the treatment of refractory tuberculous meningitis. Methods: Sixty-eight patients with refractory tuberculous meningitis treated in our hospital from December 2011 to December 2014 were randomly divided into observation group (34 cases) and control group (34 cases) .Moxifloxacin or levofloxacin Anti-TB drugs for treatment. Clinical efficacy, cerebrospinal fluid related indicators, quality of life scores and adverse reactions were observed and compared between the two groups. Results: After treatment, the cerebrospinal fluid pressure, protein content and white blood cell count were significantly decreased and the glucose content was significantly increased in both groups (P <0.05). The changes in the observation group were significantly greater than those in the control group (P <0.05) ). The total effective rate in observation group was significantly higher than that in control group, the difference was statistically significant (P <0.05). The scores of PF, RP, BP, GH and VT in the observation group were significantly higher than those in the control group (P <0.05). There was no significant difference between the two groups in the dimensions of SF, RE and MH P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: The combination of moxifloxacin and anti-tuberculosis drugs is superior to levofloxacin in the treatment of refractory tuberculous meningitis, which is safe and worthy of clinical application.