结核性脑膜炎颅神经损害与脑脊液特点的关系研究  

The Analysis of Cranial Nerves Compromised of Tuberculous Meningitis and Cerebrospinal Fluid Characteristics

作　　者：李小波 米芳 杨毅宁 代文 贾宏阁 

机构地区：[1]第四军医大学第一附属医院神经内科,陕西西安710032

出　　处：《现代生物医学进展》2016年第10期1901-1904,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81171181)

摘　　要：目的:探讨结核性脑膜炎颅神经损害与脑脊液特点的关系。方法:回顾性收集我院神经内科确诊的173例结核性脑膜炎患者临床资料,将所有患者分为伴颅神经损害和不伴颅神经损害两组,对其临床特点及脑脊液外观、压力及细胞学、生化、免疫球蛋白结果进行统计学分析。结果:颅神经损害者占所有病人的22.5%(39/173),视神经损害占61.5%(24/39),外展神经损害占53.8%(21/39),动眼神经损害占15.4%(6/39),听神经损害占15.4%(6/39);颅神经损伤组较无颅神经损伤组脑脊液压力、蛋白质及Ig G、Ig M、Alb明显升高(P<0.01或0.001),且颅神经损害者头颅MRI脑膜强化较无颅神经损害者差异有统计学意义(P<0.001),而脑脊液外观、白细胞计数及比例两组间并无发现显著差异。结论:结核性脑膜炎患者伴颅神经损害时,脑脊液压力、蛋白质及部分免疫球蛋白较无颅神经损害者明显升高,这将有助于结核性脑膜炎合并颅神经损害的临床诊断,对于有颅神经损害的结核性脑膜膜炎患者加强并早期启动抗结核治疗,以减少蛋白质沉积,从而降低颅神经损害的发生率。Objective： To explore the relationship between the cranial Nerves Compromised of tuberculous meningitis and cerebrospinal fluid characteristics. Methods： The clinical data of 173 patients was retrospective collected, the patient who was treated in the neurology of Xijing Hospital in the period of in Jun. 2010 to Jul. 2015. According to whether with cranial Nerves Compromised or not, the patients were divided into group A（with cranial Nerves Compromised） and group B（not with cranial Nerves Compromised）, and then analyzed the two groups of clinical characteristics and CSF cytology, biochemical and immune globulin, which used statistical software. Results： The injury of cranial nerve accounted for 22.5 % of all patients（39/173）, Opticus nerve compromised was 61.5 %（24/39）, abducent nerve injury accounted for 53.8 %（21/39）, oculomotor nerve damage was 15.4 %（6/39）, auditory nerve damage was15.4 %（6/39）; no significant increase in CSF pressure, and protein, Ig G, Ig M, Alb with cranial nerve injury cranial nerve injury group（P〈0.01 or 0.001）, and cranial nerve injury of cranial MRI is no meningeal enhancement of cranial nerve injury was statistically significant（P〈0.001）, while the appearance of CSF pressure, white blood cell count and the ratio between the two groups had no significant difference. Conclusions： In patients with tuberculous meningitis, the cerebrospinal fluid pressure, proteins and some of them are significantly higher than those without cranial nerve damage, which will be helpful to the clinical diagnosis of tuberculous meningitis combined with cranial nerve compromised.

关 键 词：结核性脑膜炎 颅神经 脑脊液 回顾性分析 

分 类 号：R529.3[医药卫生—内科学]