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论文摘要

181例成人社区获得性急性细菌性脑膜炎病原学、临床预后及危险因素分析

Etiology, Prognosis and Risk Factors of 181 Adult Community-acquired Acute Bacterial Meningitis

作者:龙芳, 陈乾来, 吴思颖等

Author:LONG Fang, CHEN Qian-lai, WU Si-ying. et al

收稿日期:          年卷(期)页码:2018,49(5):808-811

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:社区获得性 急性细菌性脑膜炎 临床预后 危险因素

Key words:Community acquired Acute bacterial meningitis Prognosis Risk factor

基金项目:

中文摘要

目的 了解成人社区获得性急性细菌性脑膜炎患者的病原学组成、临床预后及危险因素,为临床合理诊治提供依据。方法 对2010年1月至2018年1月确诊的181例社区获得性成人急性细菌性脑膜炎住院患者进行回顾性分析,比较非老年组(n=156)及老年组(≥65岁,n=25)患者的病原学组成及临床特征;以出院时患者的情况为截点,比较两组患者的预后及危险因素。 结果 181例患者中有64例患者(35.4%)检出病原菌,前三位分别为肺炎链球菌(17.9%),单核细胞增生李斯特菌(13.4%),肺炎克雷伯菌(10.5%)。统计分析显示老年组高血压患病率、低钾血症患病率、肺部感染率、耳鼻喉感染率、CSF蛋白浓度、头部CT检查的异常率、病死率均高于非老年组(P

英文摘要

Objective To understand the etiology, clinical prognosis and risk factors of adult community-acquired acute bacterial meningitis (ABM) and provide the evidence for clinical diagnosis and treatment. Methods We performed a retrospective study of 181 clinically diagnosed hospitalized patients with community-acquired adult ABM from Jan.2010 to Jan.2018. The patients were categorized as non-elderly (16≤age<65 years old, n=156 ) and elderly (age≥65 years old, n=25) group. The etiology, clinical features, prognosis and risk factors of the two groups were compared. Results Sixty-four of 181 patients (35.4%) had pathogens detected. The most common pathogens were Streptococcus pneumoniae (17.9%), Listeria monocytogenes (13.4%) and Klebsiella pneumoniae (10.5%). The mortality of the elderly group was higher than that of the non-elderly group (PStreptococcus pneumoniae, Listeria monocytogenes and Klebsiella pneumoniae.Pulmonary infection and temperature ≥38.5 ℃ are independent risk factors of poor prognosis in the non-elderly patients, as CSF pressure ≥200 mmH2O a independent risk factor in the elderly patients.

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