摘要
目的探讨婴儿化脓性脑膜炎不良预后的危险因素。方法选取90例0~1岁化脓性脑膜炎患儿,所有患儿随访1~4年,根据临床预后分为预后良好组和预后不良组,比较2组患儿早期临床表现、实验室指标及治疗情况等,采用单因素和多因素Logistic回归分析婴儿化脓性脑膜炎不良预后的危险因素。结果预后良好组68例,预后不良组22例,预后不良组肌张力改变发生率、血白细胞计数异常发生率、脑脊液培养阳性发生率、脑脊液白细胞计数>1 500×106/L发生率、脑脊液蛋白浓度>2 000 mg/L发生率均显著高于预后良好组,脑脊液糖浓度显著低于预后良好组,脑脊液LDH、降钙素原、CRP均显著高于预后良好组(均P<0.05);多因素Logistic回归分析显示脑脊液蛋白浓度>2 000 mg/L、脑脊液白细胞计数>1 500×106/L、抽搐、意识减弱是婴儿化脓性脑膜炎不良预后的独立危险因素(P<0.05)。结论脑脊液蛋白浓度>2 000 mg/L、脑脊液白细胞计数>1 500×106/L、抽搐、意识减弱是婴儿化脓性脑膜炎不良预后的独立危险因素。
Objective To investigate the risk factors of poor prognosis of infant purulent meningitis. Methods Ninety ca- ses of infant with purulent meningitis were selected and divided into the good prognosis group and the poor prognosis group according to the clinical outcome. All patients were followed up for one to four years. In the two groups, early clinical man- ifestations ,laboratory parameters and treatment, etc. were recorded and compared by using univariate and multivariate Lo- gistic regression analysis. Results In the good prognosis group （68 cases） muscle tension change rate, seizures inci- dence of anterior fontanelle change rate,pupil changes incidence and diminished consciousness incidence of anemia were all significantly higher than those indexes in the good prognosis group（22 cases） ;In the poor prognosis group white blood cell count abnormal incidence, cerebrospinal fluid culture positive rate, cerebrospinal fluid white blood cell count 〉 1 500 x 106/L incidence and cerebrospinal fluid protein concentration of 〉 2 000 mg/L the incidence were significantly higher than those indexes in the good prognosis group （ all P 〈 0.05 ） ; In the poor prognosis group calcitonin original and CRP were significantly higher than those in the good prognosis group （ all P 〈 0.05 ）. Multivariate Logistic regression analysis showed that CSF protein concentration 〉 2 000 mg/L, CSF leukocyte count 〉 1 500 × 10^6/L, convulsions, and reduced consciousness were all independent prognostic factors for adverse infant purulent meningitis （ P 〈 0.05 ）. Conclusion Factors including CSF protein concentration of 〉 2 000 mg/L, CSF leukocyte count 〉 1 500 × 10^6/L, convulsions and de- creased consciousness are all independent risk factors for adverse infant purulent meningitis poor prognosis.
出处
《中华全科医学》
2017年第3期460-462,共3页
Chinese Journal of General Practice
