新疆三级专科医院成人结核性脑膜炎的预后因素回顾性分析

Prognostic Factors for Tuberculous Meningitis: A Study in a Third-Level,Specialized Hospital

目的探讨新疆地区结核性脑膜炎预后的影响因素。方法回顾性整理108例确诊为结核性脑膜炎(tuberculous meningitis,TBM)的成年患者临床特点,临床表现,实验室检查结果,成像数据及治疗因素进行分析,通过单因素分析和多因素回归分析,确定患者预后的影响因素。结果老年、意识障碍和脑积水是死亡率的独立危险因素,延迟抗结核治疗与死亡率增加有关,附属的类固醇治疗2周改善症状,但超过4周的使用对死亡率没有显著影响。结论老年、TBM的晚期患者,脑积水都是TBM有不良预后的相关因素。TBM的早期诊断与治疗,包括短期使用类固醇,将有助于成人结核性脑膜炎预后的改善。

Objective To explore the prognostic factors for tuberculous meningitis （TBM） in Xinjiang. Methods Retrospective analysis was performed on the clinical manifestations, laboratory test results, imaging data and therapeutic factors among 108 adult patients who were diagnosed with TBM in Xinjiang Chest Hospital. Univariate analysis and multivariate regression analysis were performed to determine the prognostic factors for TBM. Results Old age, respiratory disorder and hydrocephaly were identified as independent risk factors for mortality; delayed anti-tuberculosis treatment was associated with increased mortality; Adjunctive steroid treatment for 2 weeks resulted in symptoms improvement, while such treatment for over 4 weeks had no significant impact on mortality. Conclusion Old age, advanced TBM and hydrocephaly are correlation factors for poor prognosis. Early diagnosis and treatment of TBM and rational use of steroids are favorable for improving prognosis of adult TBM.