摘要
目的探讨结核性脑膜炎的临床特征并分析预后影响因素。方法对2016-2018年安徽医科大学第一附属医院42例结核性脑膜炎患者临床资料进行回顾性研究,分析临床特征及预后影响因素。结果患者常见临床症状为发热(95.24%)、头痛(78.57%)、恶心呕吐(54.76%);临床体征常见为脑膜刺激症(71.43%)、意识障碍(61.90%)、外周神经功能障碍(54.76%)。脑脊液检查白细胞计数、蛋白、糖、氯化物含量异常者分别占100%、95.24%、78.57%、90.48%。39例行头颅影像学检查,常见表现为脑膜炎改变(46.15%),急性期脑梗塞(10.26%),颅内出血(7.69%)。42例中预后不良13例(30.95%)。多因素分析显示外周神经功能障碍、颅神经麻痹、脑脊液蛋白含量升高为结核性脑膜炎预后不良的独立危险因素。结论结核性脑膜炎临床特征多样,部分患者缺乏典型临床表现。结核性脑膜炎预后影响因素复杂,在临床诊疗中应注意观察。
Objective To explore the clinical features and prognostic factors of tuberculous meningitis.Methods The clinical data of 42 patients with tuberculous meningitis were retrospectively analyzed to explore the clinical features and prognostic factors in the First Affiliated Hospital of Anhui Medical University from 2016 to 2018.Results Common clinical symptoms of tuberculous meningitis were fever(95.24%),headache(78.57%),nausea and vomiting(54.76%);clinical signs were meningeal irritation(71.43%),disturbance of consciousness(61.90%)and peripheral neurological dysfunction(54.76%).Cerebrospinal fluid examination of white blood cell count,protein,glucose and chloride content abnormality were accounted for 100%,95.24%,78.57%and 90.48%,respectively.The most common findings in 39 cases examined by cranial imaging were meningitis(46.15%),acute cerebral infarction(10.26%),and intracranial hemorrhage(7.69%).Among 42 patients,13 patients had poor prognosis(30.95%).Multivariate analysis results showed that peripheral nerve dysfunction,cranial⁃nerve palsy,high cerebrospinal fluid protein content were poor⁃prognostic independent risk factors for tuberculosis meningitis.Conclusion The clinical features of tuberculous meningitis were diverse and some patients lack of typical clinical manifestations.Factors affecting the prognosis of tuberculous meningitis were complex,and attention should be paid to clinical diagnosis and treatment.
作者
张莉
马雪娇
李家斌
ZHANG Li;MA Xue⁃jiao;LI Jia⁃bin(Department of Infectious Disease,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)
出处
《热带医学杂志》
CAS
2020年第5期667-670,共4页
Journal of Tropical Medicine
基金
国家自然科学基金项目(81673242
81973983)。
关键词
结核性脑膜炎
临床特征
预后
危险因素
Tuberculous meningitis
Clinical features
Prognosis
Risk factors
