47例婴幼儿结核性脑膜炎早期临床特点分析

Analysis of clinical characterisitcs of 47 baby tubercles meningitis patiens in early period

目的通过对婴幼儿结核性脑膜炎早期临床特点分析，探讨婴幼儿结核性脑膜炎临床早期诊断。方法对我院2001～2005年共收治婴幼儿结核性脑膜炎47例早期临床特点分析，并以同期收治的非小儿结核性脑膜炎54例作对照。结果婴幼儿结核性脑膜炎患儿均并有肺结核。并且年龄越小，并Ⅱ型肺结核越多（P〈O．01）。临床表现以急性起病，常伴高热、昏迷、性格改变及脑膜刺激症为多见。婴幼儿组中71．8％患儿并脑积水，但其脑膜刺激症发生率与对照组相似。婴幼儿结核性脑膜炎患儿脑脊液均有蛋白异常及糖含量异常。结论小儿结核性脑膜炎多发生于3岁以下婴幼儿；大部分患儿并有Ⅱ型肺结核。临床上可疑结核性脑膜炎患儿应及时作胸部x线检查有助于其诊断。在婴幼儿患者中，即使并有脑水肿，其颅内压增高症状表现不明显。

Objective To explore diagnostic means of baby tubercle meningitis patients in their earlier development period through analyzing the clinical characteristics. Methods We analyzed the earlier clinical features of 47 baby patients with tubercle meningitis who were treated in our hospital from 2001 to 2005, and compared those with other 54 patients who had suffered from the same disease in the same time period （ the controls）. Results All the patients in the baby group had pulmonary tuberculosis, and they were younger and had higher rate of Type Ⅱ pulmonary tuberculosis than the controls（P 〈0.01 ）. The clinical features in the baby group showed an acute disease development in the early period, with high fever, fainted, personality change and meningeal irritation symptoms. While 71.8% of the babies in the baby group had hydrocephalus, the rate of the meningeal irritation symptoms in the beth groups was about the same. All patients in the beth groups had abnormal protein content and sugar content. Conclusion Children with tubercle meningitis most occur in infant under 3 and most have Type Ⅱ pulmonary tuberculosis.