摘要
目的探讨100mg或200mg异烟肼(INH)鞘内注射治疗对结核性脑膜炎(TBM)伴轻度焦虑抑郁患者的精神状态及脑脊液生化指标的影响。方法选取我院2016年8月~2019年8月期间收治的85例TBM伴轻度焦虑抑郁患者作为主要研究对象。按随机数字表法将研究对象随机分为小剂量组和大剂量组。在常规抗结核和口服帕罗西汀片治疗基础上,小剂量组(42例)给予鞘内注射100mg INH,大剂量组(43例)给予鞘内注射200mg INH,两组均每周注射1次,根据脑脊液生化指标调整注射次数,连续治疗3月后,观察对比两组患者的临床疗效、精神状态及脑脊液炎性因子水平。结果(1)大剂量组患者TBM治疗总有效率97.67%(42/43)高于小剂量组88.10%(37/42)(P<0.05);(2)治疗后,大剂量组患者的SAS及SDS评分明显低于小剂量组(P<0.05);(3)治疗后,大剂量组脑脊液生化指标改善显著优于小剂量组(P<0.05);(4)两组药物相关不良反应发生率差异无统计学意义(P>0.05)。结论INH 200mg鞘内注射联合帕罗西汀片能够显著改善TBM伴焦虑抑郁患者的精神状态,改善脑脊液细胞数、氯化物水平、蛋白含量和葡萄糖水平,在改善患者预后方面具有重要意义。
Objective To observe the effects of 100mg or 200mg isoniazid(INH)intrathecal injection combined with oral paroxetine on mental status and cerebrospinal fluid biochemical indexes of patients with tubercular meningitis(TBM)with anxiety and depression.Methods A total of eighty-five TBM patients with anxiety and depression admitted to our hospital from August 2016 to August 2019 were selected and randomly divided into two groups:low-dose group and high-dose group.On the basis of conventional anti-tuberculosis and oral paroxetine treatment,the low-dose group(42 cases)was given intrathecal injection of 100mg INH,and the high-dose group(43 cases)was given intrathecal injection of 200mg INH.Both groups were injected once a week.The injection frequency was adjusted according to the biochemical indexes of CSF.After continuous treatment for 3 months,the clinical efficacy,mental status and levels of CSF inflammatory factors were observed and compared between the two groups.Results(1)the total effective rate of TBM in the high-dose group was 97.67%(42/43)higher than that in the low-dose group(88.10%(37/42)(P<0.05).(2)after treatment,the SAS and SDS scores in the high-dose group were significantly lower than those in the low-dose group(P<0.05).(3)after treatment,the improvement range of biochemical indexes of CSF in the highdose group was significantly better than that in the low-dose group(P<0.05).(4)there was no statistically difference in the incidence of drug-related adverse reactions between the two groups(P>0.05).Conclusion INH 200mg intrathecal injection combined with paroxetine can significantly improve the mental state,improve the CSF cell number,chloride level,protein content and glucose level of TBM patients with anxiety and depression,which is of great signifi-cance in improving the prognosis of patients.
作者
王明远
赵顺现
刘小利
WANG Mingyuan;ZHAO Shunxian;LIU Xiaoli(Department of tuberculosis,the Fifth People's Hospital of Puyang City,Puyang 457000,China)
出处
《国际精神病学杂志》
2020年第3期586-589,共4页
Journal Of International Psychiatry
关键词
异烟肼
帕罗西汀片
结核性脑膜炎
脑脊液
焦虑抑郁
Isoniazid
Paxil
Tuberculous meningitis
Cerebrospinal fluid
Anxiety depression
