未成年人结核性脑膜脑炎发生缺血性脑卒中的危险因素分析  

Risk factors analysis for ischemic stroke in minors with tuberculous meningoencephalitis

作　　者：罗伟[1] 周理超 张亚林 姚景江 LUO Wei;ZHOU Lichao;ZHANG Yalin;YAO Jingjiang(Department of Radiology,Changsha Central Hospital Affiliated to University of South China,Changsha 410004,China.)

机构地区：[1]南华大学附属长沙中心医院放射科,湖南长沙410004

出　　处：《中国中西医结合影像学杂志》2023年第3期290-294,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：湖南省卫生健康委科研计划项目(20201990);长沙市中心医院重点课题项目(YNKY202118)。

摘　　要：目的:探讨未成年人结核性脑膜脑炎(TBM)发生缺血性脑卒中的危险因素及MRI表现。方法:回顾性分析164例未成年TBM患者的临床资料及MRI表现,评估其发生缺血性脑卒中的相关危险因素。结果:164例中,缺血性脑卒中47例(观察组),无缺血性脑卒中117例(对照组)。2组临床分期、症状持续时间、伴呕吐、脑膜刺激征、意识障碍、结核性脊膜炎,以及脑脊液白细胞计数与蛋白、葡萄糖、氯化物含量异常比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析发现,临床分期晚期(OR=10.704,95%CI 2.160~53.052)、症状持续时间≥30 d(OR=3.650,95%CI 1.013~13.149)、脑实质内结核灶(OR=2.254,95%CI 1.515~3.352)为未成年人TBM发生缺血性脑卒中的独立危险因素(均P<0.05)。结论:未成年人TBM发生缺血性脑卒中的独立危险因素为临床分期晚期、症状持续时间≥30 d及脑实质内结核灶。Objective:To investigate the risk factors and MRI features of ischemic stroke occured in minors with tuberculous meningoencephalitis(TBM).Methods:A retrospective analysis of the clinical data and MRI manifestations of 164 minors with TBM was performed,and the related risk factors for ischemic stroke were analyzed.Results:Among the 164 patients,47 cases had ischemic stroke(the observation group)and 117 cases had not ischemic stroke(the control group).The clinical stages,symptom duration,vomit,meningeal irritation,disturbance of consciousness,tuberculous meningitis and the abnormal count of WBC,protein,glucose,chloride in cerebrospinal fluid between the two groups had significant differences(all P<0.05).Multivariate logistic regression analysis showed that the late clinical stage(OR=10.704,95%CI 2.160~53.052),symptom duration≥30 d(OR=3.650,95%CI 1.013~13.149)and intraparenchymal tuberculosis(OR=2.254,95%CI 1.515~3.352)were the independent risk factors for ischemic stroke in TBM minors(all P<0.05).Conclusion:The independent risk factors for ischemic stroke in minors with TBM are the late clinical stage,symptom duration≥30 d and intraparenchymal tuberculosis.

关 键 词：结核性脑膜脑炎 缺血性脑卒中 危险因素 磁共振成像 

分 类 号：R529.3[医药卫生—内科学]