目的 系統(tǒng)評價利奈唑胺聯(lián)合抗結(jié)核藥物治療結(jié)核性腦膜炎的臨床療效和安全性。方法 檢索PubMed、CochraneLibrary、EMbase、Web of science、中國生物醫(yī)學(xué)數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫等國內(nèi)外數(shù)據(jù)庫，搜索發(fā)表于2020年7月13日前的關(guān)于利奈唑胺聯(lián)合抗結(jié)核藥物治療結(jié)核性腦膜炎的臨床隨機(jī)對照試驗（RCT）。由2位研究者提取文獻(xiàn)資料及進(jìn)行方法學(xué)質(zhì)量評價，利用Revman 5.2和STATA 10.0軟件進(jìn)行Meta分析。結(jié)果 共納入17篇RCTs，包含1 196例患者。Meta分析結(jié)果顯示：利奈唑胺聯(lián)合抗結(jié)核藥治療結(jié)核性腦膜炎的有效率高于對照組（OR=3.53，95% CI=2.09~5.95，P<0.05）；聯(lián)合治療4周后，試驗組腦脊液壓力（SMD=-50.79，95% CI=-53.86~47.72，P<0.05）指標(biāo)和格拉斯哥昏迷指數(shù)評分（SMD=1.22，95% CI=0.97~1.48，P<0.05）優(yōu)于對照組；在不良反應(yīng)方面，4周內(nèi)利奈唑胺聯(lián)合抗結(jié)核藥治療組的不良反應(yīng)發(fā)生率與對照組近似（RR=1.12，95% CI=0.90~1.38，P=0.32）。結(jié)論 當(dāng)前證據(jù)表明利奈唑胺聯(lián)合抗結(jié)核藥物治療結(jié)核性腦膜炎有較好的臨床療效，不良反應(yīng)發(fā)生率與對照組相近，且可防可控，故該藥用于治療結(jié)核性腦膜炎值得臨床推廣應(yīng)用。

Object To systematically evaluate the efficacy and security of treating Tuberculous Meningitis by using linezolid combined with antituberculosis drugs. Methods Such databases as PubMed, Cochrane Library, EMBASE, Web of science, CNKI, CBM, VIP and Wanfang Database, were searched to collect randomized controlled trials (RCT) concerning linezolid combined with antituberculosis drugs for treating tuberculous meningitis published from the emergence of these databases to 13th July 2020. There were two researchers screening the studies, extracting the data and assessing the methodology quality. Revman 5.2 and STATA 10.0 was used to execute the meta-analysis. Results A total of 17 RCTs involving 1 196 patients were included. Meta-analysis showed that the effective rate of observation group with linezolid plus antituberculosis drugs was higher than control group (OR=3.53, 95%CI=2.09 to 5.95, P<0.05). After four-week treatment with linezolid plus antituberculosis drugs, there was a significant improvement between observation group and control group in indexes of cerebrospinal fluid pressure (SMD=-50.79, 95%CI=-53.86 to 47.72, P<0.05). and GCS score (SMD=1.22, 95%CI=0.97 to 1.48, P<0.05). Moreover, in terms of adverse reactions rate, group with Linezolid combined Antituberculosis Drugs was similar to that in control group. Conclusion As is showed in these evidences, compared to antituberculosis drugs, treating tuberculous meningitis with linezolid plus antituberculosis drugs has a better clinical therapeutic effect. The incidence of adverse reactions of this group is similar to the control group, which can be properly prevented and controlled. Thus, treating tuberculous meningitis with linezolid pulsing antituberculosis drugs is worthy to popularization and application.

R978.3