婴幼儿化脓性脑膜炎合并硬膜下积液的危险因素分析
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摘要
目的探讨婴幼儿化脓性脑膜炎合并硬膜下积液的危险因素。方法回顾性分析2014年1月至2017年12月中国医科大学附属盛京医院小儿重症监护病房收治的52例婴幼儿化脓性脑膜炎患儿的相关临床资料。其中合并硬膜下积液者为观察组,未合并硬膜下积液者为对照组,应用SPSS 20.0软件进行统计学分析。结果 2组间外周血血红蛋白、血清C反应蛋白、脑脊液中蛋白定量水平差异具有统计学意义(P<0.05),Logistic回归分析提示外周血血红蛋白(OR=0.940,95%CI:0.899～0.998)、血清C反应蛋白(OR=1.015,95%CI:1.004～1.028)及脑脊液中蛋白定量水平(OR=2.490,95%CI:1.151～6.315)是合并硬膜下积液的独立危险因素(P<0.05)。结论诊断为化脓性脑膜炎的婴幼儿外周血血红蛋白减低,血清C反应蛋白及脑脊液蛋白定量水平增高者易合并硬膜下积液。
Objective To investigate the risk factors of purulent meningitis complicated with subdural effusion in infants and young children. Methods The clinical data of the infants and young children who were diagnosed with purulent meningitis in PICU of Shengjing Hospital of China Medical University from January 2014 to December 2017 were analyzed retrospectively.All of them were divided into 2 groups according to whether there was complication of subdural effusion. The statistical data were analyzed by SPSS 20.0 software. Results There were significant differences in hemoglobin,C reactive protein and protein in cerebrospinal fluid between control group and subdural effusion group(P<0.05). Logistic regression analysis showed that hemoglobin(OR=0.940,95%CI:0.899—0.998),C reactive protein(OR=1.015,95%CI:1.004—1.028)and protein in cerebrospinal fluid(OR=2.490,95%CI:1.151—6.315)were independent risk factors for purulent meningitis complicated with subdural effusion(P<0.05). Conclusion Infants and young children diagnosed with purulent meningitis are with lower hemoglobin. Higher C reactive protein and higher protein in cerebrospinal fluid are likely to be complicated with subdural effusion.
Objective To investigate the risk factors of purulent meningitis complicated with subdural effusion in infants and young children. Methods The clinical data of the infants and young children who were diagnosed with purulent meningitis in PICU of Shengjing Hospital of China Medical University from January 2014 to December 2017 were analyzed retrospectively.All of them were divided into 2 groups according to whether there was complication of subdural effusion. The statistical data were analyzed by SPSS 20.0 software. Results There were significant differences in hemoglobin,C reactive protein and protein in cerebrospinal fluid between control group and subdural effusion group(P<0.05). Logistic regression analysis showed that hemoglobin(OR=0.940,95%CI:0.899—0.998),C reactive protein(OR=1.015,95%CI:1.004—1.028)and protein in cerebrospinal fluid(OR=2.490,95%CI:1.151—6.315)were independent risk factors for purulent meningitis complicated with subdural effusion(P<0.05). Conclusion Infants and young children diagnosed with purulent meningitis are with lower hemoglobin. Higher C reactive protein and higher protein in cerebrospinal fluid are likely to be complicated with subdural effusion.
引文
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[13]蓝明平,蒋莉.婴儿化脓性脑膜炎并发硬膜下积液的早期诊断[J].重庆医科大学学报,2015,40(1):82-87.
[14]张二清,陈荷英,李绍英,等.儿童化脓性脑膜炎不良预后危险因素探讨[J].临床儿科杂志,2011,29(2):148-152.
[15]宋小青,吴洁.细菌性脑膜炎早期并发症的预警因素[J].实用儿科临床杂志,2007,22(8):615-616.
[16]Cornelis AS,Hachimi-Idrissi S.The use of dexamethasone in bacterial meningitis in children and adults:A retrospective analysis[J].ISRN Pediatr,2011,2011:380283.
[17]江志,杨理明,张洁,等.细菌性脑膜炎并发硬膜下积液危险因素分析[J].中国现代神经疾病杂志,2015,15(8):667-671.
[2]胡超平,周水珍,张林妹,等.小儿化脓性脑膜炎66例诊疗分析[J].中国实用儿科杂志,2012,27(3):206-208.
[3]江载芳,申昆玲,沈颖.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:981-1003.
[4]Amarilyo G,Alper A,Ben-Tov A,et al.Diagnostic accuracy of clinical symptoms and signs in children with meningitis[J].Pediatr Emerg Care,2011,27(3):196-199.
[5]Kasanmoentalib ES,Brouwer MC,van de Beek D.Update on bacterial meningitis:epidemiology,trials and genetic association studies[J].Curr Opin Neurol,2013,26(3):282-288.
[6]王晓明,郭启勇,林楠,等.婴幼儿脑外积液的MRI研究:脑外间隙发育性与病理性的扩大[J].中华放射学杂志,2006,40(5):470-474.
[7]Vasilopoulou VA,Karanika M,Theodoridou K,et al.Prognostic factors related to sequelae in childhood bacterial meningitis:data from a Greek meningitis registry[J].BMC Infect Dis,2011,11(1):214.
[8]Castelblanco RL,Lee M,Hasbun R.Epidemioligy of bacterial meningitis in the USA from 1997 to 2010:a population-based observational study[J].Lacent Infect Dis,2014,14(9):813-819.
[9]雷梅芳,张玉琴,郭静.B族链球菌相关小婴儿化脓性脑膜炎22例临床分析[J].中国实用儿科杂志,2015,30(9):696-700.
[10]Rubin AN,Shcherbuk YA,Lyapin AP.Complications of purulent meningoencephalitis in children[J].Vestn Khir Im IIGrek,2015,174(1):43-46.
[11]Imataka G,Miyamoto K,Fujiyama Y,et a1.Acute purulent meningitis associated with chronic subdural hematoma and subdural hygroma[J].Turk J Pediatr,2007,49(2):437-440
[12]宋亚娟,石磊,张志昱.全程C-反应蛋白用于儿童急性细菌性脑膜炎诊断价值研究[J].中国实用儿科杂志,2013,25(8):620-621.
[13]蓝明平,蒋莉.婴儿化脓性脑膜炎并发硬膜下积液的早期诊断[J].重庆医科大学学报,2015,40(1):82-87.
[14]张二清,陈荷英,李绍英,等.儿童化脓性脑膜炎不良预后危险因素探讨[J].临床儿科杂志,2011,29(2):148-152.
[15]宋小青,吴洁.细菌性脑膜炎早期并发症的预警因素[J].实用儿科临床杂志,2007,22(8):615-616.
[16]Cornelis AS,Hachimi-Idrissi S.The use of dexamethasone in bacterial meningitis in children and adults:A retrospective analysis[J].ISRN Pediatr,2011,2011:380283.
[17]江志,杨理明,张洁,等.细菌性脑膜炎并发硬膜下积液危险因素分析[J].中国现代神经疾病杂志,2015,15(8):667-671.