未成年人结核性脑膜脑炎发生缺血性脑卒中的危险因素分析

Risk factors analysis for ischemic stroke in minors with tuberculous meningoencephalitis

目的:探讨未成年人结核性脑膜脑炎(TBM)发生缺血性脑卒中的危险因素及MRI表现。方法:回顾性分析164例未成年TBM患者的临床资料及MRI表现,评估其发生缺血性脑卒中的相关危险因素。结果:164例中,缺血性脑卒中47例(观察组),无缺血性脑卒中117例(对照组)。2组临床分期、症状持续时间、伴呕吐、脑膜刺激征、意识障碍、结核性脊膜炎,以及脑脊液白细胞计数与蛋白、葡萄糖、氯化物含量异常比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析发现,临床分期晚期(OR=10.704,95%CI 2.160~53.052)、症状持续时间≥30 d(OR=3.650,95%CI 1.013~13.149)、脑实质内结核灶(OR=2.254,95%CI 1.515~3.352)为未成年人TBM发生缺血性脑卒中的独立危险因素(均P<0.05)。结论:未成年人TBM发生缺血性脑卒中的独立危险因素为临床分期晚期、症状持续时间≥30 d及脑实质内结核灶。

Objective:To investigate the risk factors and MRI features of ischemic stroke occured in minors with tuberculous meningoencephalitis(TBM).Methods:A retrospective analysis of the clinical data and MRI manifestations of 164 minors with TBM was performed,and the related risk factors for ischemic stroke were analyzed.Results:Among the 164 patients,47 cases had ischemic stroke(the observation group)and 117 cases had not ischemic stroke(the control group).The clinical stages,symptom duration,vomit,meningeal irritation,disturbance of consciousness,tuberculous meningitis and the abnormal count of WBC,protein,glucose,chloride in cerebrospinal fluid between the two groups had significant differences(all P<0.05).Multivariate logistic regression analysis showed that the late clinical stage(OR=10.704,95%CI 2.160~53.052),symptom duration≥30 d(OR=3.650,95%CI 1.013~13.149)and intraparenchymal tuberculosis(OR=2.254,95%CI 1.515~3.352)were the independent risk factors for ischemic stroke in TBM minors(all P<0.05).Conclusion:The independent risk factors for ischemic stroke in minors with TBM are the late clinical stage,symptom duration≥30 d and intraparenchymal tuberculosis.