【作者】 陈颜强； 李军霞； 张雪萍； 白洪忠； 郑立恒； 李雯；

【Author】 CHEN Yan-qiang;LI Jun-xia;ZHANG Xue-ping;BAI Hong-zhong;ZHENG Li-heng;LI Wen;Department of Neurology,the Chest Hospital of Hebei Province;Department of Obstetrics and Gynecology,the Chest Hospital of Hebei Province;Department of Medical,the Chest Hospital of Hebei Province;Department of Clinical Laboratory,the Fifth Hospital of Shijiazhuang City,Hebei Province;Department of Medical Imaging,the Chest Hospital of Hebei Province;

【机构】 河北省胸科医院神经内科； 河北省胸科医院妇产科； 河北省胸科医院医务处； 河北省石家庄市第五医院检验科； 河北省胸科医院影像科；

【摘要】 目的探讨难治性结核性脑膜炎的影响因素。方法将99例结核性脑膜炎患者分为普通结核性脑膜炎组和难治性结核性脑膜炎组,对2组患者的临床特点、脑脊液指标、影像学分型、抗结核药物方案、激素应用、椎管注药等方面进行分析。结果难治组病程>3个月、院外抗结核药物、弱方案、脑膜强化比例高于普通组,初治强四化比例低于普通组,白细胞数高于普通组,脑脊液氯、ADA水平低于普通组(P<0.05)。Logistic回归分析,结果显示,院前抗结核(OR=0.196)、弱方案(OR=0.116)、脑脊液低氯(OR=0.780)是难治型结核性脑膜炎的危险因素。结论脑脊液低氯是难治性结核性脑膜炎的预测因素,抗结核方案的强弱对结核性脑膜炎预后有很大影响。更多还原

【Abstract】 Objective To investigate the influencing factors of refractory tuberculous meningitis.Methods 99 patients with tuberculous meningitis were divided into ordinary tuberculous meningitis group and refractory tuberculous meningitis group,the clinical features,Cerebrospinal fluid index,image credits,anti-tb drugs,hormone application and vertebral canal injection medicine were analyzed of 2 groups.Results Univariate analysis showed that disease progression(>3 months),applied anti-tb drugs outside the hospital,combination of autoimmune disease,difference of anti-tuberculosis program,cerebrospinal fluid indicators(number of cells,chlorine value,ADA) and meninges strengthening in the 2 groups of patients had significant differences(P <0.05).Multiple Logistic regression analysis showed that pre-hospital chemotherapy(OR=0.196),weak resistance to tuberculosis scheme(OR=0.116),low chloride of cerebrospinal fluid(OR=0.780) tend to refractory tuberculous meningitis group.Conclusion Low chlorine of Cerebrospinal fluid is an independent predictor of refractory tuberculous meningitis,the strength of the chemotherapy scheme has a great influence on tuberculous meningitis.更多还原