结核性脑膜炎近期预后的影响因素研究

Influential Factors on Short-term Prognosis of Tuberculous Meningitis

目的探讨结核性脑膜炎患者近期预后的影响因素。方法以患者出院时好转或恶化/死亡为转归指标,对105例结核性脑膜炎患者的一般临床资料、实验室检查、神经影像学检查等因素进行分析。通过单因素分析和二分类多因素Logistic回归分析,确定患者预后的影响因素。结果单因素分析显示,好转组与恶化/死亡组患者的意识障碍、血白细胞计数、脑肿胀间差异有统计学意义(P<0.05);多因素分析结果显示,入院时的意识障碍和脑脊液氯化物水平降低为影响预后的独立危险因素。结论入院时即有意识障碍和脑脊液氯化物水平降低的结核性脑膜炎患者,临床预后较差。

Objective To assess the short-term prognosis in patients with tuberculous meningitis（TBM） and its influential factors. Methods The outcomes of improvement on discharge,or deterioration/death were taken as the index to analyze general clinical data,the parameters of laboratory and nuero-imaging examinations of the 105 TBM patients.And univariate and binary multivariate Logistic regression analyses were taken to determine the influential factors to prognosis of the patients. Results The univariate analysis showed that there were statistically significant differences between the improved group and deteriorated/death group in conscious level,blood white-cell count,and radiographic evidence of brain swelling（P0.05）.The multivariate Logistic regression analysis showed that the decreased chloride levels of cerebrospinal fluid and decreased level of consciousness on admission were independently associated with the short-term poor outcome. Conclusion The patients with tuberculous meningitis who have decreased chloride levels of cerebrospinal fluid and decreased level of consciousness have poorer clinical prognosis.