结核性脑膜炎患者预后情况调查及其相关影响因素分析  

Investigation of Prognosis of Tuberculous Meningitis Patients and Analysis of Related Influencing Factors

作　　者：刘子林[1] 肖绍武[1] 叶琳[1] 况卫丰[1] 张丽婷[1] 周丽 张齐龙[1] LIU Zilin;XIAO Shaowu;YE Lin;KUANG Weifeng;ZHANG Liting;ZHOU Li;ZHANG Qilong(Chest Hospital of Jiangxi Province,Nanchang 330006,China;不详)

机构地区：[1]江西省胸科医院,江西南昌330006

出　　处：《中国医学创新》2021年第35期69-72,共4页Medical Innovation of China

基　　金：江西省科技创新基地计划-江西省感染性疾病临床医学研究中心项目(2020BCG74004)。

摘　　要：目的:探讨结核性脑膜炎(tuberculous meningitis,TBM)患者预后情况及其相关影响因素。方法:回顾性分析2019年1月-2021年7月就诊于本院的60例TBM患者的临床资料,分析TBM患者预后情况及其相关影响因素。结果:60例TBM患者中,预后良好39例(65.00%),预后不良21例(35.00%)。单因素分析显示,脑积水、意识障碍、脑脊液蛋白含量、脑脊液氯化物含量与TBM患者预后有关,差异均有统计学意义(P<0.05)。年龄、治疗前病程、性别、肢体瘫痪、癫痫发作、疾病分期、激素治疗、合并颅外结核、脑压、脑脊液葡萄糖含量和白细胞计数与TBM患者预后无关,差异均无统计学意义(P>0.05)。多因素分析显示,脑积水、意识障碍、脑脊液蛋白含量≥4 000 g/L、脑脊液氯化物含量<115 mmol/L是影响TBM患者预后的危险因素(P<0.05)。结论:TBM患者预后较差,其受脑积水、意识障碍、脑脊液蛋白含量、脑脊液氯化物含量影响。Objective:To investigate the prognosis and related factors of tuberculous meningitis (TBM).Method:The clinical data of 60 TBM patients admitted to our hospital from January 2019 to July 2021 were retrospectively analyzed,and the prognosis and related factors of TBM patients were analyzed.Result:Among the 60 patients with TBM,39 cases (65.00%) had good prognosis and 21 cases (35.00%) had poor prognosis.Univariate analysis showed that hydrocephalus,disturbance of consciousness,CSF protein content and CSF chloride content were correlated with prognosis of TBM patients,the differences were statistically significant (P<0.05).Age,course of disease before treatment,gender,paralysis of limbs,seizures,disease stage,hormone therapy,extracranial tuberculosis,brain pressure,CSF glucose content and white blood cell count had no significant differences in prognosis of TBM patients (P>0.05).Multivariate analysis showed that hydrocephalus,disturbance of consciousness,cerebrospinal fluid protein content ≥4 000 g/L,cerebrospinal fluid chloride content <115 mmol/L were high risk factors for prognosis of TBM patients (P<0.05).Conclusion:TBM patients have a poor prognosis,which is affected by hydrocephalus,disturbance of consciousness,CSF protein content and CSF chloride content.

关 键 词：结核性脑膜炎 脑积水 预后 意识障碍 

分 类 号：R529.3[医药卫生—内科学]