结核性脑膜炎继发癫痫的临床特征及预后分析

Clinical Features and Prognosis of Patients with Epilepsy Secondary to Tuberculous Meningitis

本研究通过比较结核性脑膜炎（TBM）继发癫痫与未继发癫痫患者的临床表现和预后的差别,探讨结核性脑膜炎继发癫痫患者的临床特点和预后关系,为改善结核性脑膜炎患者的预后提供依据。选取2012年6月至2017年2月桂林医学院附属医院、桂林医学院第二附属医院诊断为TBM的152例患者,回顾性分析其临床特点,记录患者的癫痫发作情况、影像学资料、脑电图改变、治疗效果和预后等。结果显示,152例TBM患者中继发癫痫16例（10.52%）,继发癫痫与未继发癫痫患者性别、年龄比较差异均无统计学意义（p〉0.05）;影像学发现,TBM继发癫痫患者的脑积水要比未继发癫痫患者严重（p〈0.05）,TBM继发癫痫患者的腺苷脱氨酶与未继发癫痫患者的比较无明显差异（p〉0.05）,TBM患者继发癫痫与未继发癫痫患者预后比较,差异有统计学意义（Z=4.748,p〈0.01）。本研究发现TBM继发癫痫患者表现为病情程度较严重、治疗效果差、病死率高的特点,对TBM继发癫痫患者早期用药和积极抗癫痫治疗对改善结核性脑膜炎的预后至关重要。

This study compared the clinical manifestations and prognosis of patients with epilepsy secondary to TBE secondary epilepsy and explored the clinical features and prognosis of patients with secondary epilepsy of tuberculous meningitis（TBM） in order to improve the prognosis of patients with tuberculous meningitis.Provide evidence.A total of 152 patients with TBM diagnosed at the Affiliated Hospital of Guilin Medical College and the Second Affiliated Hospital of Guilin Medical College from June 2012 to February 2017 were selected,and their clinical features were retrospectively analyzed to record the patient＇s seizure status,imaging data,and brain.Electrograph changes,treatment effects and prognosis.The results showed that there were 152 consecutive TBE patients with epilepsy in 16 cases（10.52%）.There was no significant difference in gender and age between patients with secondary epilepsy and those without secondary epilepsy（p〈0.05）.Imaging findings showed that secondary TBM The hydrocephalus in patients with epilepsy was more severe than that in patients without secondary epilepsy（p〈0.05）.There was no significant difference between adenosine deaminase in patients with TBM secondary epilepsy and those without secondary epilepsy（p〈0.05）,followed by TBM patients.The difference in prognosis between patients with epilepsy and those without epilepsy was statistically significant（Z=4.748,p〈0.01）.This study found that TBM secondary epilepsy patients are characterized by severe disease severity,poor treatment,and high mortality.Early treatment of patients with TBM secondary epilepsy and active antiepileptic treatment are essential to improve the prognosis of tuberculous meningitis.