Analysis Of The Correlation Between The Cerebrospinal Fluid Trough Concentration Of Linezolid And Clinical Efficacy In Patients With Tuberculous Meningitis

Objective: Through monitoring the concentration of linezolid Valley in different treatment periods of tuberculous meningitis(TBM),the therapeutic value and course of treatment of TBM were discussed.Methods: From January 2017 to June 2018,30 TBM patients treated with HRZE +linezolid were selected as the study group,and 35 TBM patients treated with HRZE alone were selected as the control group.The clinical symptoms,blood and cerebrospinal spine of TBM patients before and after treatment were compared between the two groups.The changes of biochemical indexes and the concentration of linazolamide valley were recorded.The adverse drug reactions during treatment were also recorded.Results:In terms of clinical efficacy,the recovery of consciousness and body temperature in the treatment group was significantly faster than that in the control group.In terms of the changes of biochemical indexes of cerebrospinal fluid:intra-group comparison: although the blood concentration of linezolid reached steady state after 5 days of anti-tuberculosis treatment,there should be no significant difference between the two groups at this time.After one month of treatment,with the progress of treatment,the indexes of the two groups changed significantly,the difference was statistically significant(P < 0.05).The index of each point showed a step change,and the difference of each time point had statistical significance(P <0.05),while the biochemical index of cerebrospinal fluid in the control group was not as obvious as that in the study and observation group at each time point after one month of treatment.Inter-group comparison: In the study group,there were significant differences in cerebrospinal fluid protein,cell number,cerebrospinal fluid glucose/plasma glucose,chloride,ADA and other biochemical indicators in different treatment periods compared with the control group(P < 0.05).After 24 weeks of treatment,the total effective rate of the study group was significantly better than that of the control group,except for protein and ADA,there were still statisticaldifferences in other biochemical indicators between the two groups.Linazolamide reached the cerebrospinal fluid trough concentration through the blood-brain barrier in the ratio of plasma trough concentration,12 weeks before TBM treatment was significantly higher than the latter;the study group in the recovery rate(90%)was significantly higher than the control group,the difference between the groups was statistically significant(P < 0.05).The curative effect of the study group was significantly better than that of the control group.The 2 Analysis of multiple constituent ratios showed that there was a significant difference between the two groups(P < 0.05).The incidence of peripheral neuritis,liver damage,optic neuritis,bone marrow depression,hyperuricemia,gastrointestinal discomfort and candidiasis in the study group was higher than that in the control group,but there was no significant difference between the two groups(P > 0.05).In terms of the ratio of the cerebrospinal fluid trough concentration to plasma trough concentration through the blood-brain barrier,linezolid was significantly higher 12 weeks before TBM treatment than at the later stage,and this ratio had no significant correlation with the biochemical indicators of cerebrospinal fluid.Conclusion: On the basis of HRZE routine anti-tuberculosis,linezolid can significantly improve the clinical symptoms of TBM patients and the expression level of biochemical indicators in cerebrospinal fluid,promote the curative effect and shorten the course of treatment.The suitable course of linezolid treatment is 12 weeks(3 months).