宁夏地区成人化脓性脑膜炎脑脊液细菌构成及特点

发布时间：2019-03-07 23:41

【摘要】：目的分析宁夏地区成人化脓性脑膜炎(purulent meningitis in adult,APM)脑脊液细菌构成,并探讨其细菌培养阳性患者的特点。方法收集我院近13年来收治的201例APM患者的临床资料,回顾性分析144例行细菌培养的脑脊液细菌构成并比较致病菌检出阳性病例(CP组)与阴性病例(CN组)的临床及实验室特点。结果 APM的细菌检出阳性率为36.81%,致病菌以革兰阳性球菌常见(64.15%),其中以凝固酶阴性葡萄球菌最多,金黄色葡萄球菌次之;CP组年龄、男性病例数、以意识障碍及癫痫发作表现者显著高于CN组(P0.05),且其血中性粒细胞比例、脑脊液白细胞计数及脑脊液蛋白含量均较CN组高(P0.05);在发病10 d内就诊的患者,CP组脑脊液压力、脑脊液白细胞计数、脑脊液中性粒细胞比例均较CN组高,脑脊液淋巴细胞比例较CN组低(P0.05)。结论成人APM的致病菌以革兰阳性球菌多见,其细菌培养阳性患者的临床特点与培养阴性者有差异,可早期预测细菌培养结果。
[Abstract]:Objective to analyze the bacterial composition of cerebrospinal fluid (CSF) in adults with purulent meningitis (purulent meningitis in adult,APM) in Ningxia, and to explore the characteristics of the patients with positive bacterial culture. Methods the clinical data of 201 APM patients admitted in our hospital in recent 13 years were collected. The bacterial composition of cerebrospinal fluid (CSF) in 144 cases of bacterial culture was analyzed retrospectively and the clinical and laboratory characteristics of the positive cases (CP group) and the negative case (CN group) were compared. Results the positive rate of APM was 36.81%. Gram-positive cocci (64.15%) was the most common pathogen, among which coagulase-negative staphylococcus was the most, Staphylococcus aureus was the second. The age, number of male cases, disturbance of consciousness and seizures in CP group were significantly higher than those in CN group (P0.05), and the ratio of neutrophils in blood, leukocyte count in CSF and protein content in CSF were higher than those in CN group (P0.05). The CSF pressure, CSF leukocyte count, CSF neutrophil ratio and CSF lymphocyte ratio in CP group were higher than those in CN group, and the percentage of CSF lymphocytes was lower than that in CN group (P0.05). Conclusion Gram-positive cocci is the most common pathogen of APM in adults. The clinical characteristics of the patients with positive bacterial culture are different from those with negative bacterial culture. The results of bacterial culture can be predicted in the early stage.
【作者单位】：宁夏医科大学临床医学院;宁夏医科大学总医院脑脊液细胞学研究室;宁夏医科大学总医院神经病学中心宁夏颅脑重点实验室;
【基金】：国家自然科学基金地区科学基金(81160151)
【分类号】：R515.2

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