Analysis of the Curative Effect and Prognosis of 32 Cases of Drug Resistant Tuberculosis Meningitis_West China Medical Journal

Authors：

 DengQian ,  LaiXiaohui

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LaiXiaohui, Email: lxhneu@aliyun.com

Keywords：

Tuberculous meningitis; Drug resistance; Curative effect; Prognosis

DOI：

10.7507/1002-0179.20160058

Video：

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Objective To analyze the curative effect and prognosis of drug resistant tuberculosis meningitis (TBM). Methods Retrospective analysis was carried out on the clinical data of thirty-two cases of drug resistant tuberculous meningitis patients hospitalized from January 2010 to December 2015. And the prognosis of the patients was evaluated by meliorated Rankin Scale (mRS). Results Thirty-one cases (96.9%) were improved in 32 patients with drug resistant TBM, and 1 case (3.1%) was ineffective. After treatment, one patient had hormone-related glaucoma and osteoporosis, and one patient had drug Cushing syndrome. Twenty-seven patients (84.4%) had an mRS score equal to or less than 2 points. Conclusion Drug resistant TBM is difficult to diagnose in the early stage, and the curative effect is satisfying with active anti-tuberculosis treatment.

Citation： DengQian, LaiXiaohui. Analysis of the Curative Effect and Prognosis of 32 Cases of Drug Resistant Tuberculosis Meningitis. West China Medical Journal, 2016, 31(2): 208-211. doi: 10.7507/1002-0179.20160058 Copy

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17.	张艳虹. 高原地区儿童结核性脑膜炎临床特征及早期诊断探讨[J]. 医学综述, 2011, 17(16):2552-2553.
18.	王郁. 结核性脑膜炎临床诊断与治疗分析——附48例报道[J]. 中国医药指南, 2011, 9(26):64-65.
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1. World Health Organization. Global tuberculosis control:surveillance, planning, financing. WHO report WHO/HTM/TB/2007.376[R]. Geneva:World Health Organization, 2007.
2. Zumla A, Raviglione M, Hafner R, et al. Tuberculosis[J]. N Engl J Med, 2013, 368(8):745-755.
3. Liao PW, Chiang TR, Lee MC, et al. Tuberculosis with meningitis, myeloradiculitis, arachnoiditis and hydrocephalus:a case report[J]. Acta Neurol Taiwan, 2010, 19(3):189-193.
4. Lienhardt C, Fielding K, Sillah JS, et al. Investigation of the risk factors for tuberculosis:a case-control study in three countries in West Africa[J]. Int J Epidemiol, 2005, 34(4):914-923.
5. Lienhardt C, Bennett S, Del Prete G, et al. Investigation of environmental and host-related risk factors for tuberculosis in Africa. I. Methodological aspects of a combined design[J]. Am J Epidemiol, 2002, 155(11):1066-1073.
6. Wright A. Anti-tuberculosis drug resistance in the world. Fourth Global Report:the WHO/IUATLD Global Project on Anti-tuberculosis Drug Resistance Surveillance[M]. 4th ed. Geneva:World Health Organization, 2008.
7. 闫世明, 孙秀娟, 邹志艳, 等. 不同剂量地塞米松治疗结核性脑膜炎的对比观察[J]. 中华结核和呼吸杂志, 1995, 18(4):236.
8. 刘风霞, 刘雪云, 战云飞. 结核性脑膜炎96例临床分析[J]. 临床肺科杂志, 2012, 17(3):471-472.
9. 中华医学会. 临床诊疗指南结核病学分册[M]. 北京:人民卫生出版社, 2009:58-61.
10. 刘建民, 关玲, 侯红革, 等. 结核性脑膜炎120例临床分析[J]. 中国实用神经疾病杂志, 2012, 15(20):66-67.
11. 孙冲, 徐迪荣, 李碧磊. 改良Rankin量表在急性大面积脑梗死长期生存的预后价值[J]. 医学研究杂志, 2012, 41(12):179-182.
12. World Health Organization. Global tuberculosis control 2009:epidemiology strategy financing[M]. http://reliefweb.int/sites/reliefweb.int/files/resources/878BDA5E2504C9F449257584001B5E60-who_mar2009.pdf.
13. 王黎霞. 中国耐多药结核病的控制亟待加强[J]. 中华结核和呼吸杂志, 2009, 32(8):561-563.
14. 马玙, 朱莉贞, 潘毓萱. 结核病[M]. 北京:人民卫生出版社, 2006:254-262.
15. Mizutani T, Kurosawa N, Matsuno Y, et al. A typical manifestation of tubeiculous meninpitis[J]. Eur Nenrol, 1993, 33(2):159-162.
16. 赵钢, 杜芳. 结核性脑膜炎临床诊断思路[J]. 中国现代神经疾病杂志, 2013, 13(1):1-4.
17. 张艳虹. 高原地区儿童结核性脑膜炎临床特征及早期诊断探讨[J]. 医学综述, 2011, 17(16):2552-2553.
18. 王郁. 结核性脑膜炎临床诊断与治疗分析——附48例报道[J]. 中国医药指南, 2011, 9(26):64-65.
19. Panicker JN, Nagaraja D, Subbakrishna DK, et al. Role of the BACTEC radiometric method in the evaluation of patients with clinically probable tuberculous meningitis[J]. Ann Indian Acad Neurol, 2010, 13(2):128-131.
20. 叶叔文, 王明杰, 邹建勋, 等. 脑结核的CT及MR诊断[J]. 浙江中西医结合杂志, 2012, 22(1):51-53.
21. Prasad K, Singh MB. Corticosteroids for managing tuberculous meningitis[J]. Cochrane Database Syst Rev, 2008(1):CD002244.
22. Sinner SW, Tunkel AR. Approach to the diagnosis and management of tuberculous meningitis[J]. Curr Infect Dis Rep, 2002, 4(4):324-331.
23. 张鲁军, 刘丽, 赵巧华. 35例结核性脑膜炎临床死亡原因分析[J]. 宁夏医学杂志, 2005, 27(2):134.
24. Brancusi F, Farrar J, Heemskerk D. Tuberculous meningitis in adults:a review of a decade of developments focusing on prognostic factors for outcome[J]. Future Microbiol, 2012, 7(9):1101-1116.

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Analysis of the Curative Effect and Prognosis of 32 Cases of Drug Resistant Tuberculosis Meningitis

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