改良抗酸染色阳性的170例结核性脑膜炎脑脊液分析

发布时间：2018-05-30 14:41

本文选题：结核性脑膜炎 + 脑脊液　；参考：《中国神经精神疾病杂志》2017年04期

【摘要】：目的探讨改良抗酸染色阳性结核性脑膜炎患者的脑脊液特点。方法纳入170例临床诊断为结核性脑膜炎且改良抗酸染色呈阳性患者,收集其一般临床资料,并对抗酸染色阳性出现时间、脑脊液细胞学分型及抗结核药物对抗酸染色的影响进行统计分析。结果 128例结核性脑膜炎患者脑脊液首次抗酸染色阳性出现在发病1个月内(75.3%),其细胞学分型包括混杂细胞反应、淋巴细胞反应、嗜中性粒细胞反应、正常细胞学,分别占15.5%、58.5%、19.5%、6.5%;24例结核性脑膜炎患者脑脊液首次抗酸染色阳性出现在发病1~2个月的病例,以上细胞学类型分别占13.1%、56.5%、21.7%及8.7%;18例结核性脑膜炎患者脑脊液首次抗酸染色阳性出现在发病2个月以上的病例,四种细胞学分别占26.7%、46.7%、20.0%、6.6%。各种细胞学类型出现时间中位数,四组比较差异无统计学意义(P=0.812)。应用抗结核药物的患者其抗酸染色阳性中位时间(据发病时间)21.5(12.3,37.8)d;未应用抗结核药物者抗酸染色阳性中位时间8.5(6.0,16.3)d,两组比较差异有统计学意义(P0.001)。应用抗结核药物的患者抗酸染色转阴中位数时间11(5.75,19.25)d;未应用抗结核药物者抗酸染色转阴中位数时间6(4.25,10.75)d,两组比较差异无统计学意义(P=0.230)。结论结核性脑膜炎脑脊液改良抗酸染色首次阳性多发生于发病1个月内,其阳性时的细胞学类型与抗酸阳性时间无关,应用抗结核药物可能会推迟抗酸杆菌检出时间。
[Abstract]:Objective to investigate the cerebrospinal fluid (CSF) features of patients with modified acid-fast positive tuberculous meningitis. Methods 170 patients with tuberculous meningitis and positive for modified acid-fast staining were collected and their general clinical data were collected. The effects of cerebrospinal fluid cytological classification and anti-acid staining of anti-tuberculosis drugs were statistically analyzed. Results in 128 patients with tuberculous meningitis, the first positive reaction of anti-acid staining in cerebrospinal fluid appeared within one month. The cytological types included mixed cell reaction, lymphocyte reaction, neutrophil reaction and normal cytology. The first time acid-fast staining positive in cerebrospinal fluid of 24 patients with tuberculous meningitis occurred within 1 to 2 months after the onset of tuberculous meningitis. The above cytological types accounted for 21. 7% and 8. 7% respectively in 18 patients with tuberculous meningitis who had the first positive acid stain in cerebrospinal fluid for more than 2 months. The four cytology types accounted for 26. 7% and 20. 0% respectively. There was no significant difference between the four groups in the median time of occurrence of various cytological types (P < 0. 812). The median time of positive acid-fast staining in patients with antituberculotic drugs was 21.5 ~ 12.37.8d (according to the onset time), and the median time of anti-tuberculosis drugs was 8.56.0or 16.3drespectively. The difference between the two groups was statistically significant (P 0.001). There was no significant difference between the two groups in the median time of anti-tuberculosis staining to negative in patients with anti-tuberculosis drugs was 115.75 ~ 19.25 days, and that in patients without antituberculous drugs was 64.25 ~ 10.75 days. There was no significant difference between the two groups. Conclusion the first time of modified acid resistance staining in cerebrospinal fluid of tuberculous meningitis occurred within one month, and the cytological type of positive cerebrospinal fluid was not related to the time of acid-fast positive. The detection time of acid-fast bacilli might be delayed by the use of antituberculous drugs.
【作者单位】：河北医科大学第二医院;
【基金】：河北省医学适用技术跟踪项目(编号:GL2012026)
【分类号】：R529.3

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