结核性脑膜炎65例临床分析  

Retrospective analysis of 65 cases of tuberculous meningitis

作　　者：刘袁媛[1] 欧强[1] 王冯滨[1] 

机构地区：[1]上海市公共卫生临床中心复旦大学附属公共卫生临床中心,201508

出　　处：《中国感染与化疗杂志》2011年第1期13-15,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析结核性脑膜炎的临床表现、诊断和治疗特点,以提高对该病的正确诊治率。方法对上海市公共卫生临床中心2006年7月—2009年10月收治的65例结核性脑膜炎的临床资料、实验室检查结果、诊断及预后情况进行回顾分析。结果本组65例结核性脑膜炎多呈慢性或亚急性起病,临床表现仍以发热、头痛、呕吐为主,脑脊液改变以压力高、白细胞高、蛋白升高、低葡萄糖、低氯为主。49%合并颅外结核。头颅CT或MRI检查异常11例,表现为脑积水、结核瘤、脑室扩张、多发病灶等。经正规抗结核治疗,52例患者治疗后好转,10例未见好转,自动出院或转院治疗,3例死亡。结论患者的临床表现、脑脊液、头颅CT或MRI检查、是否合并颅外结核感染以及正规抗结核治疗是否有效,是诊断结核性脑膜炎的重要依据。Objective To review the clinical and laboratory features of tuberculous meningitis （TM） in order to improve the diagnostic level of tuberculous meningitis. Methods Sixty five cases of TM during the last three years in our hospital were analyzed retrospectively. Results The main clinical manifestations of tuberculous meningitis are still fever, headache, and vomiting. Abnormality of cerebrospinal fluid includes increased pressure, white blood cell count, and increased protein level, hut low levels of glucose and chlorine. Eighty percent （80%） of the cases were cured following conventional anti-tuberculous treatment. Unsuccessful treatment or death was reported in 13 （20%） cases. Conclusions The clinical manifestations, cerebrospinal fluid findings, head CT or MRI to find extrapulmonary tuberculosis and diagnostic antituberculous treatment are important for improving the diagnosis of tuberculous meningitis. Early diagnosis and treatment can improve the cure rate.

关 键 词：结核性脑膜炎 临床分析 脑脊液 诊断 预后 

分 类 号：R529.3[医药卫生—内科学]