65例小儿结核性脑膜炎的临床表现  

Clinical and Imaging Manifestation of 65 Cases of Tuberculosis Meningitis in Children

作　　者：陈凤民[1] 任纯明[1] 

机构地区：[1]河南省人民医院儿科,郑州450003

出　　处：《医学研究杂志》2011年第12期115-117,共3页Journal of Medical Research

摘　　要：目的探讨小儿结核性脑膜炎的临床诊断方法。方法对每例患者常规做脑脊液检查、PPD试验、X线胸片、头颅CT或MRI,11例患者做了结核分枝杆菌特异性抗原(ESAT-6)测定。结果 PPD试验阳性率47.9%,ESAT-6试验阳性率81.8%,脑脊液糖和氯化物同时降低者72.3%,X线胸片异常率为32.3%,头颅CT、MRI异常率分别为75.4%、100%。结论小儿结核性脑膜炎临床表现的多样性及缺乏特异性的检查方法,给早期诊断带来很大困难,提高对本病的认识,积极寻找结核感染的证据,动态观察脑脊液及头颅CT、MRI变化,可以提高本病的正确诊断率,对改善预后有重要意义。Objective To investigate the clinical diagnosis method for pediatric tuberculosis meningitis.Methods Each patient underwent routine cerebrospinal fluid examination,PPD test,chest ⅹ-ray,CT or MRI,11 patients underwent a mycobacterium tuberculosis-specific antigen（ESAT-6） determination.Results PPD test had positive rate of 47.9% and ESAT-6 test 81.8%.While the rates of both the cerebrospinal fluid sugar and chloride reducing were 72.3%.Rate of chest ⅹ ray abnormality were 32.3%,and rates of head CT,MRI abnormalities were 75.4% and 100%.Conclusion The clinical manifestations of tuberculosis meningitis in children′s diversity and the lack of specific screening method caused great difficulties for early diagnosis.Improved understanding of the disease,actively looking for evidence of TB infection,dynamic observation of cerebrospinal fluid and cranial CT,MRI changes,can improve the correct diagnosis of this disease,and is important for improring prognosis.

关 键 词：小儿 结核 脑膜炎 CT MRI 

分 类 号：R529.3[医药卫生—内科学]