布鲁氏菌病中枢神经系统损害患者脑脊液临床特征分析  

Clinical characteristics of cerebrospinal fluid in patients with central nervous system damage caused by brucellosis

作　　者：程大伟 陈雪英 李美楠 Cheng Dawei;Chen Xueying;Li Meinan(Department of Infectious Diseases,Beidahuang Group General Hospital,Harbin 150088,China)

机构地区：[1]北大荒集团总医院感染科,哈尔滨150088

出　　处：《中华地方病学杂志》2025年第3期237-240,共4页Chinese Journal of Endemiology

摘　　要：目的分析布鲁氏菌病(布病)中枢神经系统损害患者脑脊液临床特征,探讨其在布病临床诊断中的价值。方法采用回顾性分析方法,收集2007年12月至2022年12月在北大荒集团总医院感染科住院并经临床确诊的布病中枢神经系统损害患者的病历资料,分析其流行病学、临床特征及脑脊液检测结果。结果布病中枢神经系统损害患者共50例,其中男性32例、女性18例,年龄范围为18~72岁、中位数为45岁。全部患者均存在羊接触史。50例患者中,合并脑膜炎15例(30.0%)、脑膜脑炎5例(10.0%)、脊髓炎28例(56.0%),脑脓肿2例(4.0%),肢体运动、感觉功能障碍29例(58.0%),恶心呕吐以及颈椎强直22例(44.0%),抽搐以及持续昏迷4例(8.0%)。48例患者出现脑脊液异常改变,其中30例存在颅内压增高现象(均>200 mmH 2O,1 mmH 2O=0.0098 kPa),脑脊液白细胞计数升高者40例,球蛋白含量升高者47例,葡萄糖以及氯化物含量下降者分别为38、40例。结论布病中枢神经系统损害患者临床表现多样,多见脑脊液生化分析异常,流行病学接触史及脑脊液检测对其诊断具有重要价值。Objective To analyze the clinical characteristics of cerebrospinal fluid(CSF)in patients with central nervous system(CNS)damage caused by brucellosis and to explore its value in the clinical diagnosis of brucellosis.Methods A retrospective analysis was conducted on medical records of patients with CNS damage due to brucellosis who were admitted to the Department of Infectious Diseases,Beidahuang Group General Hospital from December 2007 to December 2022.Epidemiological,clinical features,and CSF test results were analyzed.Results There were a total of 50 patients with CNS damage caused by brucellosis,including 32 males and 18 females,with an age range of 18 to 72 years and a median of 45 years.All patients had a history of sheep contact.Among the 50 patients,15 case(30.0%)had combined meningitis,5 case(10.0%)had meningoencephalitis,28 case(56.0%)had myelitis,2 case(4.0%)had brain abscesses,29 cases(58.0%)had limb motor and sensory dysfunction,22 case(44.0%)had nausea,vomiting,and cervical stiffness,and 4 case(8.0%)experienced seizures and persistent coma.Abnormal CSF changes were observed in 48 patients,including increased intracranial pressure(>200 mmH 2O,1 mmH 2O=0.0098 kPa)in 30 cases,elevated white blood cell count in 40 cases,increased globulin levels in 47 cases,and decreased glucose and chloride levels in 38 and 40 cases,respectively.Conclusions Patients with CNS damage caused by brucellosis exhibit diverse clinical manifestations,and abnormalities in CSF biochemical analysis are relatively commom.Epidemiological contact history and CSF analysis are of significant diagnostic value.

关 键 词：布鲁氏菌病 中枢神经系统 脑脊液 

分 类 号：R516.7[医药卫生—内科学]