新疆地区结核性脑膜炎的临床特点和预后因素分析

Xinjiang region the clinical characteristics and prognosis of tuberculous meningitis factor analysis

目的描述新疆地区结核性脑膜炎(TBM)患者(年龄>18岁)的临床特点,分析影响预后因素。方法回顾性收集纳入患者的病例资料,描述临床特点,采用单因素与多因素Logistic回归分析影响预后因素。结果 200例TBM患者中,男120例,女80例,年龄18～75(37.35±14.24)岁,病程3～270(36.86±43.86)d。存活179例,死亡21例,死亡率10.5%。单因素分析显示存活组与死亡组之间脑积水、脑水肿、临床分期、血沉、脑脊液(CSF)-蛋白差异有统计学意义(P均<0.05),经多因素Logistic回归分析,脑水肿和血沉是TBM预后的独立影响因素(P均<0.05)。结论脑水肿、血沉是TBM患者预后不良的独立危险因素,早期识别预测影响因素,制定相应临床对策,可改善结核性脑膜炎患者的预后。

Objective To describe the Xinjiang region of tuberculous meningitis （TBM） （ age 〉 18 years of age） in patients with the clinical features, analysis of factors influencing the prognosis. Methods A retrospective of cases included in the data collection, describe the clinical characteristics, using the single factor and multiple factors Logistic regression analysis of factors imquencing the prognosis. Results A total of 200 cases of TBM patients had the following characteristics： 120 cases of male, female 80 cases; age 18 - 75 （ 37.35 -＋ 14. 24） years old ; the course of the disease 3 - 270 （ 36. 86 -＋ 43.86） days ; and 179 cases of survival, 21 cases of death, with a mortality of 10. 5%. Single factor analysis showed that hydrocephalus, encephaledema, clinical staging, erythrocyte sedimenLation rate, cerebro-spinal fluid （CSF）-protein had statistically significant difference between survival group and death group, respectively （ P 〈 0. 05 ）. The multi-factor Logistic regression analysis showed that encephaledema and erythrocyte sedimentation rate were independent factors to affect the prognosis of TBM （P 〈 O. 05）. Conclusions Encephaledema and erythro- cyte sedimentation rate are independent risk factors of poor prognosis in patients with TBM, early identify predictors, formulate corresponding clinical countermeasures, and can improve the prognosis of patients with tuberculous meningitis.