颅内感染患者脑膜刺激征阴性的影响因素  

The influent factor to the negative signs of meningeal irritation in the intracranial infective patients

作　　者：陈智泉[1] 梁卫东[1] 曾碧凤[1] 

机构地区：[1]福建医科大学附属闽东医院急诊科,福建福安355000

出　　处：《中国医药科学》2012年第24期18-19,65,共3页China Medicine And Pharmacy

摘　　要：目的探讨颅内感染患者出现脑膜刺激征阴性的影响因素。方法收集颅内感染患者269例,根据体格检查结果,分为脑膜刺激征阳性组和阴性组。记录患者一般情况、首诊时间、病史、体征、脑脊液检查和影像学结果等,比较两组间的差异,并进行Logistic回归分析。结果 269例患者中,脑膜刺激征阴性149例,阳性120例。病毒性颅内感染70.6%阴性,化脓性颅内感染16.7%阴性(P<0.05)。意识障碍、病理征、颅内压升高、脑脊液氯化物水平以及脑实质受累与脑膜刺激征阴性有关(P<0.05)。结论病毒感染、意识障碍、病理征阳性、脑脊液氯化物水平降低或脑实质受累的颅内感染患者容易出现脑膜刺激征阴性,颅内压升高的患者容易出现脑膜刺激征阳性。Objective To investigate the influent factor to the negative signs of meningeal irritation in the intracranial infective patients. Methods 269 cases of intracranial infection were included and divided into two groups：the negative and positive signs of meningeal irritation groups,depending on physical examination. The data of the patients were recorded, including general data,onset time,symptoms,signs,examination of cerebrospinal fluid and neuroimaging. The data were compared between two groups and logistic regression analysis was done. Results In all of the cases,149 cases showed the negative signs of meningeal irritation and 120 cases showed the positive signs. 70.6% cases showed negative signs in the viral infection while 16.7% in the bacterial infection（P 〈 0.05）. Conscious disturbance,pyramidal tract signs,intracranial pressure,level of chloridate in cerebrospinal fluid and parenchyma involved were found to be relevant to the meningeal irritation signs（P 〈 0.05）. Conclusion The cases with viral infection,conscious disturbance,positive pyramidal tract signs,lower level of chloridate in cerebrospinal fluid or parenchyma involved are easy to show the negative meningeal irritation signs. And the case with increased intracranial pressure are easy to show the positive meningeal irritation signs.

关 键 词：颅内感染 脑膜刺激征 阴性 

分 类 号：R741.04[医药卫生—神经病学与精神病学]