53例成人化脓性脑膜炎临床特点及其复发的影响因素  

Clinical characteristics and factors influencing recurrence in 53 adults with purulent meningitis

作　　者：胡二尧 尹俊雄[2] 张纪红 陆杰[2] 林兴建[2] 孙丰[2] HU Eryao;YIN Junxiong;ZHANG Jihong(Department of Neurology,Third People's Hospital of Lishui District,Nanjing 211200,CHINA)

机构地区：[1]南京市溧水区第三人民医院神经内科,江苏211200 [2]南京医科大学附属脑科医院神经内科

出　　处：《江苏医药》2020年第12期1251-1254,共4页Jiangsu Medical Journal

基　　金：南京市科技计划项目(201803029);南京市卫生科技发展一般课题项目(YKK18114)。

摘　　要：目的分析成人化脓性脑膜炎的临床特点和治疗方案,探讨影响复发的相关因素。方法回顾性分析53例成人化脓性脑膜炎患者的临床资料。1~8年随访中,13例患者复发。采用单因素和多因素logistic回归分析探讨化脓性脑膜炎患者复发的影响因素。结果成人化脓性脑膜炎患者主要临床表现为发热、头痛,脑脊液检查白细胞计数、脑脊液蛋白升高,脑脊液糖、氯化物降低。多因素logistic回归分析结果显示,发病-治疗间隔时间长是患者复发的独立危险因素(P<0.05)。以发病-治疗的间隔时间与复发绘制ROC曲线,结果显示曲线下面积为0.750[95%CI(0.558~0.942)],发病-治疗的间隔时间预测化脓性脑膜炎复发的最佳界值为7.5 d,相应的灵敏度为76.9%,特异度为75.0%。结论成人化脓性脑膜炎发病-治疗间隔时间超过1周提示复发风险可能更高。Objective To analyze the clinical characteristics and treatments of adult purulent meningitis and explore the factors influencing recurrence.Methods The clinical data of 53 adult patients with purulent meningitis were retrospectively analyzed.The patients were followed up for 1 to 8 years,during which 13 patients were relapsed.The univariate and multivariate logistic regression analysis methods were used to analyze the factors affecting the recurrence.Results The main clinical manifestations of adult patients with purulent meningitis were fever,headache and so on.Cerebrospinal fluid examination showed that the white blood cell count and cerebrospinal fluid protein of patients were significantly increased,while cerebrospinal fluid sugar and chloride were decreased.The results of multivariate logistic regression analysis showed that the long interval time from onset to treatment was an independent risk factor for recurrence(P<0.05).ROC curve of interval time from onset to treatment showed that the area under the curve for predicting the recurrence of purulent meningitis was 0.750[95%CI(0.558-0.942)].Taking 7.5 days as the best cut-off value for predicting the recurrence,the corresponding sensitivity and specificity were 76.9%and 75.0%,respectively.Conclusion The interval time from onset to treatment≥1 week indicates an increased risk for recurrence of adult patients with purulent meningitis.

关 键 词：化脓性脑膜炎 

分 类 号：R742[医药卫生—神经病学与精神病学]