结核性脑膜炎预后不良的因素分析

Analysis of Adverse Factors of Prognosis of Tuberculous Meningitis

目的探讨结核性脑膜炎(TBM)预后不良的因素。方法回顾性分析2010年9月至2014年6月恩施市中心医院收治的112例TBM患儿的临床资料,采用单因素与多因素Logistic回归分析可能影响患儿预后的因素。结果 112例患儿中,预后不良患儿43例(38.4%),预后良好患儿69例(61.6%);预后不良组与预后良好组在肢体瘫痪发生率、脑积水发生率、格拉斯哥昏迷评分(GCS)及蛋白含量方面比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,脑积水、GCS评分及脑脊液蛋白含量为TBM预后不良的危险因素。结论脑积水、GCS评分及脑脊液蛋白水平为影响TBM预后不良的危险因素,应在实际过程中对其进行观察,改善患儿预后状况。

Objective To study the factors of poor prognosis of tuberculous meningitis（ TBM）. Methods The clinical data of 112 children with TBM admitted to Enshi Central Hospital from Sep. 2010 to Jun. 2014 were retrospectively analyzed,single factor and multiple-factor Logistic regression analysis were done to figure out factors influencing the prognosis. Results Among the 112 cases,there were 43 cases（ 38. 4%） of poor prognosis and 69 cases（ 61. 6%） of good prognosis. The incidence of limb paralysis,the incidence of hydrocephalus,Glasgow coma scale（ GCS）,and protein content of the poor prognosis group and good prognosis group had statistically significant differences（ P〈0. 05）. Multiple Logistic regression analysis indicated that hydrocephalus,GCS score and cerebrospinal fluid protein content were risk factors of poor prognosis of TBM.Conclusion Hydrocephalus,GCS and cerebrospinal fluid protein content are independent risk factors for poor prognosis of TBM,which require observation in the clinical practice,so as to improve the prognosis.