结核性脑膜炎123例临床分析

Clinical analysis of 123 patients with tuberculous meningitis

目的探讨结核性脑膜炎(TBM)的临床表现、影像学及脑脊液(CSF)特点。方法分析2014年12月至2017年3月在西京医院诊断治疗的123例TBM患者的病历资料。所有TBM患者被分成TBM确诊组与TBM很可能(可能)组,并分析比较两组间的差异。结果TBM确诊组与TBM很可能(可能)组患者在临床症状、持续时间、体征及并发症等指标的分析无明显差异(P>0.05)。CSF细胞学结果显示,TBM确诊组患者白细胞、中性粒细胞计数的平均中位数(四分位距)明显高于很可能(可能)组患者(P<0.05)。CSF生化结果显示:TBM确诊组患者CSF蛋白水平明显高于很可能(可能)组(P<0.01)。两组患者影像学特点差异无统计学意义(P>0.05)。结论TBM临床表现复杂,结合患者临床症状、影像学特点及CSF参数可助于早期诊断、治疗,改善预后。

Objective To investigate the clinical manifestations,imaging and cerebrospinal fluid(CSF)characteristics of tuberculous meningitis(TBM).Methods The clinical data of 123 patients with TBM in Xijing hospital from Dec 2014 to Mar 2017 were analyzed retrospectively.All the patients were classified as definite TBM group and probable(possible)TBM group,and the differences between the two groups were analyzed.Results There were no significant differences in the analysis of the clinical symptoms,duration,signs and complications between the definite TBM group and the probable(possible)TBM group(P>0.05).The CSF cytology results showed that the average median(interquartile range)of white blood cell and neutrophil counts in the definite TBM group were significantly higher than those in the probable(possible)TBM group(P<0.05).Compared with the probable(possible)TBM group,the CSF biochemical results showed that the CSF protein level of patients in the definite TBM group increased significantly(P<0.01).In addition,there was no significant difference in imaging characteristics between the two groups(P>0.05).Conclusion The clinical characteristics of TBM are complex,combining clinical symptoms,imaging and CSF parameters could contribute to early diagnosis and treatment,and improve prognosis.