成人病毒性脑膜炎62例临床分析  

Analysis of 62 adult patients with viral meningitis

作　　者：王瑞金[1] 王得新[1] 王佳伟[1] 冯子敬[1] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,北京100050

出　　处：《中华实验和临床病毒学杂志》2009年第3期218-220,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨成人病毒性脑膜炎的临床特征、脑脊液以及辅助检查特点。方法回顾性分析62例成人病毒性脑膜炎的临床资料。结果62例（100％）患者均有头痛症状，61例（98％）有发热，48例（77％）有脑膜刺激征，1例患者出现左眼外展受限，2例患者出现癫痫发作。平均病程17d，93％的患者病程短于30d。80％的患者脑脊液初压增高，91％的患者白细胞数量增多，81％的患者蛋白含量增高，35％的患者氯化物在正常范围，65％的患者氯化物稍低，均高于110mmol／L，94％的患者糖含量在正常范围。7例患者脑脊液以及血液柯萨奇病毒B组IgM抗体阳性，1例脑脊液EB病毒IgM抗体阳性。62例患者脑CT均无特异性发现，23例行脑磁共振血管造影术（MRI）检查的患者中，有9例可见脑膜强化，强化部位多位于大脑半球。52％的患者存在脑电图异常，主要表现为局部或散在慢波增多。结论成人病毒性脑膜炎是一种自限性疾病，半数以上患者脑脊液氯化物稍低，部分患者脑MRI可见脑膜强化。Objective To investigate the clinical manifestation, cerebrospinal fluid（CSF） and auxiliary examination findings of adult viral meningitis. Methods 62 adult patients with viral meningitis were retrospectively analyzed. Results Headache occurred in all the 62（ 100% ） patients, fever occurred in 61 （98 % ） patients, meningeal irritation sign occurred in 48 （77%） patients. The abduction of left eye was limited in one patient. Seizure occurred in 2 patients. The mean duration time was 17 days, 93 % patients less than 30 days. The pressure of CSF increased in 80 % patients, leukocyte counts increased in 91% patients, protein level increased in 81% patients, chloride level was normal in 35% patients and slightly lower in 65% patients, glucose level was normal in 94% patients. 7 patients had positive IgM antibody of Coxackievirus B group both in serum and CSF, one patient had positive IgM antibody of EB virus in CSF. Cranial CT scan had no special findings in all patients. 23 patients performed MRI examination, meningeal enhancement occurred in 9 patients. 52% patients had abnormal EEG, mainly increased local or diffuse slow waves. Conclusion Adult viral meningitis was a kind of self-limited disease, chloride level was slightly lower in more than half patients, meningeal enhancement was detected in MRI in part patients.

关 键 词：脑膜炎 病毒性 脑脊髓液 磁共振血管造影术 

分 类 号：R512.3[医药卫生—内科学] R511.1[医药卫生—临床医学]