新生儿化脓性脑膜炎不良预后危险因素的探讨

Analysis of risk factors on poor prognosis of purulent meningitis in neonates

目的探讨新生儿化脓性脑膜炎不良预后的危险因素。方法对58例明确诊断新生儿化脓性脑膜炎的患儿在其1岁时进行随访,分为预后不良组与预后良好组,比较两组患儿在住院期间的早期临床表现、实验室检查的差异,分析化脓性脑膜炎不良预后危险因素。结果单因素分析显示,两组患儿在惊厥、休克、肌张力异常、贫血发生率、外周血白细胞数<5×109/L或>20×109/L、脑脊液有核细胞数>500×106/L和蛋白含量、糖浓度差异均有统计学意义(P<0.05,P<0.01);多因素分析显示,脑脊液糖浓度降低和白细胞数<5×109/L或>20×109/L均为化脓性脑膜炎预后不良的危险因素(P<0.01,P<0.05)。结论脑脊液糖浓度降低和外周血白细胞异常均为新生儿化脓性脑膜炎不良预后的危险因素。

Objective To explore the risk factors of neonatal purulent meningitis with poor prognosis. Methods 58 neonates with purulent meningitis were divided into poor prognosis and good prognosis group according to the re-sults of follow-up at one age, compared the difference of two groups on clinical manifestation, laboratory examina-tion and analyzed the risk factors of poor prognosis of neonatal purulent meningitis. Results The single factor anal-ysis showed that seizures, shock, abnormal tension of muscle, anemia, peripheral blood leukocyte count （ 〈5 × 10^9/L or 〉20 × 10^9/L） , nucleated cells（ 〉500 × 10^6/L） , protein and sugar of cerebrospinal fluid, were related to poor prognosis（P〈0. 05,P〈0. 01）. Multivariate analysis showed that the low sugar concentration of cerebrospi- 〈br〉 nal fluid and peripheral blood leukocyte count （ 〈5 × 10^9/L or 〉20 × 10^9/L） were risk factors of poor prognosis of purulent meningitis in neonates. Conclusion The risk factors of poor prognosis of neonatal purulent meningitis were low sugar level of cerebrospinal fluid and abnormal peripheral blood leukocyte count.