细菌性脑膜炎并发硬膜下积液危险因素分析

Analysis on the risk factors of bacterial meningitis complicated with subdural effusion

目的探讨细菌性脑膜炎并发硬膜下积液的危险因素。方法回顾性分析细菌性脑膜炎患儿临床资料,Logistic回归分析探讨硬膜下积液危险因素。结果硬膜下积液组患儿血清降钙素原(Z=2.823,P=0.007)和脑脊液白细胞计数(Z=3.126,P=0.003)、蛋白定量(Z=4.928,P=0.000)高于对照组、脑脊液葡萄糖低于对照组(t=2.166,P=0.033)。经治疗后,硬膜下积液组患儿脑脊液白细胞计数仍高于对照组(Z=2.467,P=0.012)、葡萄糖仍低于对照组(t=4.938,P=0.000)。Logistic回归分析显示,血清降钙素原(P=0.014)和脑脊液白细胞计数(P=0.027)、蛋白定量(P=0.002)是细菌性脑膜炎并发硬膜下积液的独立危险因素。结论细菌性脑膜炎患儿血清降钙素原和脑脊液白细胞计数、蛋白定量显著升高,提示易并发硬膜下积液。

Objective To investigate the risk factors of bacterial meningitis complicated withsubdural effusion.Methods The clinical data of children with bacterial meningitis in our hospital werecollected and analyzed retrospectively. Logistic regression analysis was used to investigate the risk factorsfor subdural effusion.Results A total of 128 cases were divided into control group（N = 64） and subduraleffusion group（N = 64）. There was no significant difference on serum erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）, and white blood cell（WBC） between 2 groups（P 〉0.05, for all）. Compared withcontrol group, cerebrospinal fluid（CSF） WBC（Z = 3.126, P = 0.003）, CSF protein（Z = 4.928, P = 0.000） andserum procalcitonin（PCT; Z = 2.823, P = 0.007） in subdural effusion group were significantly higher, whileCSF glucose（t = 2.166, P = 0.033） was significantly lower. After treatment, CSF WBC（Z = 2.467, P = 0.012）in subdural effusion group was still significantly higher than that of control group, and CSF glucose（t =4.938, P = 0.000） was still significantly lower. Logistic regression analysis showed that WBC in CSF（P =0.027）, CSF protein（P = 0.002） and serum PCT（P = 0.014） were independent risk factors for bacterialmeningitis complicated with subdural effusion.Conclusions CSF examination of children with bacterialmeningitis reveals significant increase of CSF WBC, CSF protein and serum PCT, suggesting concurrentsubdural effusion is easily occurred.