成年人的慢性脑膜炎:神经结核病和神经结核病之间的比较
Matin Shirazinia1, Fereshte Sheybani2, HamidReza Naderi3
1Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC infectious diseases
|April 25, 2024
概括
区分结核性脑膜炎 (TBM) 和布鲁塞拉脑膜炎 (BM) 是一个挑战. TBM患者表现出更多的意识变化,神经外参与,以及特定的CSF/成像发现,需要仔细的诊断才能进行有效的治疗.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 结核病和白病流行地区面临的诊断挑战区分结核性脑膜炎 (TBM) 和白性脑膜炎 (BM).
- 对TBM和BM患者的临床和准临床特征需要详细的研究.
研究的目的:
- 研究和比较诊断为TBM的患者的临床和准临床特征与BM.
- 确定TBM和BM之间的关键区分因素.
主要方法:
- 对被诊断患有TBM或BM的成年患者的回顾性分析.
- 纳入标准:2015年3月至2022年10月期间入院于两家转诊医院的患者.
- 收集的数据包括临床表现,脑脊液 (CSF) 分析和神经成像发现.
主要成果:
- 与BM患者相比,TBM患者表现出更高的意识改变 (2.06倍) 和超神经参与 (4.80倍) 的风险.
- 脑脊髓分析显示,TBM中多态核白细胞 (PMN) 的百分比较高.
- 神经成像显示TBM中脑水性,心脏病发作和脑膜增强的风险增加;TBM也与更长的住院时间和更高的不良结果相关.
结论:
- TBM与意识变化增加,CSF中PMN的主导地位,神经外参与,脑水,脑膜增强和脑梗塞有关.
- 该研究强调了区分TBM和BM的诊断困难.
- 强调适当的治疗策略需要谨慎区分的重要性.
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