基于单中心的中枢神经系统感染的疾病谱及预后分析

Disease spectrum of central nervous system infection and its prognosis:a single-center analysis

目的探究中枢神经系统感染(central nervous system infection,CNSI)的疾病谱及预后分析。方法回顾性分析河南科技大学第一附属医院神经内科2019年5月至2020年12月收治的102例CNSI患者的病例资料,分析临床基线资料,统计CNSI患者的发病率、病死率。结果102例CNSI患者中化脓性脑膜炎发病率为15.7%、结核性脑膜炎发病率为20.6%、弓形虫脑膜炎发病率为16.7%、病毒性脑膜炎发病率为24.5%、脑白质并发脑病发病率为11.8%、隐球菌性脑膜炎发病率为10.8%。脑白质并发脑病死亡率为3.9%、结核性脑膜炎死亡率为2.9%、病毒性脑膜炎死亡率为3.9%、弓形虫脑膜炎死亡率为4.9%、隐球菌性脑膜炎死亡率为1.0%、化脓性脑膜炎死亡率为2.9%。进一步logistic回归分析显示精神症状、脑脊液压力升高、白细胞计数升高、影像学结果异常、年龄等因素与预后不良有关(P<0.05)。结论精神症状、脑脊液压力升高、白细胞计数升高、影像学异常、年龄与预后不良呈正相关。

Objective To explore the disease spectrum of central nervous system infection(CNSI)and its prognosis.Methods The clinical data of 102 inpatients with CNSI in the department of Neurology,the First Affiliated Hospital of Henan University of Science and Technology from May 2019 and December 2020 were retrospectively analyzed.The clinical baseline data were analyzed,and the incidence and mortality of CNSI patients were calculated.Results Among the 102 patients with CNSI,the incidence rates of purulent meningitis,tuberculous meningitis,toxoplasma meningitis,viral meningitis,cerebral white matter complicated with encephalopathy,and cryptococcal meningitis were 15.7%,20.6%,16.7%,24.5%,11.8%and 10.8%,respectively.The mortality rates of cerebral white matter complicated with encephalopathy,tuberculous meningitis,viral meningitis,toxoplasma meningitis,cryptococcal meningitis and purulent meningitis were 3.9%,2.9%,3.9%,4.9%,1.0%and 2.9%,respectvely.Logistic regression analysis showed that mental symptoms,increased cerebrospinal fluid pressure,increased white blood cell count,abnormal imaging findings and age were associated to poor prognosis(P<0.05).Conclusion Mental symptoms,increased cerebrospinal fluid pressure,increased white blood cell count,abnormal imaging findings and age are correlated with poor prognosis.