陕西省2014—2017年3种类型脑膜炎的临床特点变化
| 作者: |
1程仙送,
2李欢欢,
1吕桦,
1高俊卿
1 陕西省人民医院神经内一科，西安 710000 2 空军军医大第二附属唐都医院神经内科，西安 710000 |
| 通讯: |
李欢欢
Email: huanhuan19840620@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.11.028 |
摘要
目的：回顾性分析2014—2017年陕西省脑膜炎的临床特点。方法：2014年1月至2017年12月于陕西省人民医院和空军军医大第二附属唐都医院就诊的146例脑膜炎患者为研究对象，与2010年1月至2013年12月的136例脑膜炎患者的临床资料进行比较分析，观察两组在年龄、性别分布以及症状、体征、脑脊液等常规检查中的变化特点。结果：与对照组相比，观察组3种类型脑膜炎整体在年龄、头痛、发热、恶心呕吐、意识障碍以及脑膜刺激征(+)等临床症状和体征的发生率以及脑脊液有核细胞总数、蛋白水平方面差异具有统计学意义(P<0.05)；观察组中，结核性脑膜炎患者出现发热、恶心呕吐人数明显减少，脑脊液蛋白水平明显增加(P<0.05)，化脓性脑膜炎患者出现意识障碍人数明显减少，脑脊液蛋白水平明显增加(P<0.05)，隐球菌性脑膜炎患者发病年龄明显降低，出现头痛、发热和意识障碍人数明显减少，脑脊液有核细胞总数<100×106个/L人数明显增加，蛋白水平明显降低(P<0.05)。结论：近4年临床结核性脑膜炎、化脓性脑膜炎以及隐球菌性脑膜炎在发病年龄、临床症状及体征以及脑脊液常规和生化方面的表现均呈现出显著的改变，因此临床应及时调整对于各类型脑膜炎的认识，综合各方面临床特点的变化进行鉴别诊断。
关键词：
结核性脑膜炎；化脓性脑膜炎；隐球菌性脑膜炎；临床特点；变化
Changes of clinical features of three types of meningitis in 2014—2017 in Shaanxi Province
CorrespondingAuthor: LI Huanhuan Email: huanhuan19840620@163.com
DOI: 10.3978/j.issn.2095-6959.2018.11.028
Abstract
Objective: To retrospectively analyzed the clinical features changes of three types of meningitis in 2014—2017 in Shanxi Province. Methods: To select 146 cases of meningitis patients from January 2013 to December 2017 in Shaanxi Provincial People’s Hospital and Air Force Military Medical University, Tangdu Hospital as the research objects, and select 136 cases of patients with meningitis from January 2010 to December 2013 to comparatively analyzed, then observed the characteristics changes of age, gender distribution and the routine inspection of symptoms, signs and cerebrospinal fluid of two groups. Results: The differences in three types of the age and the incidence rate of headache, fever, nausea and vomiting, conscious disturbance and meningeal stimulation (+), etc, and the total nucleated cells and the protein level in cerebrospinal fluid between observation group and control group had statistically significant (P<0.05). In the observation group, the number of tuberculous meningitis patients with fever, nausea and vomiting was decreased significantly, the level of cerebrospinal fluid protein was increased significantly (P<0.05), the number of purulent meningitis patients with conscious disturbance was decreased significantly, the protein level of cerebrospinal fluid was increased significantly (P<0.05), the age of Cryptococcus meningitis patients was significantly lower, and the number of patients with headache, fever and conscious disturbance was significantly reduced, and the number of patients total nucleated cells of cerebrospinal fluid less than 100×106/L was increased significantly, and the protein level was significantly decreased (P<0.05). Conclusion: The manifestation of tubercular meningitis, purulent meningitis and Cryptococcal meningitis in nearly 4 years in the respects of onset ages, clinical symptoms and signs, and conventional and biochemical of cerebrospinal fluid have significantly change, therefore clinical should adjust the understanding to the various types of meningitis, and take differential diagnosis by comprehensive all aspects of clinical features.
Keywords：
tuberculous meningitis; purulent meningitis; Cryptococcal meningitis; clinical characteristics; changes