摘要
目的 以基本的临床及实验室资料为基础寻找成人结核性脑膜炎和新型隐球菌性脑膜炎的鉴别点,并建立相应诊断规则.方法 实验对象为中山大学附属第三医院2000年～2008连续住院的成人患者,包括100例结核性脑膜炎患者及119例新型隐球菌性脑膜炎患者,并分析其基本的临床及实验室资料.运用logistic回归分析寻找可独立预测结核性脑膜炎的危险因素,并建立相应的诊断规则.结果 Logistic回归分析得出六项可独立预测结核性脑膜炎的危险因素：性别、神志改变、视听损害、脑脊液蛋白、脑脊液白细胞数及合并颅外结核.利用上述因素建立的诊断规则其诊断结核性脑膜炎的灵敏度为78.0%,特异度为95.2%,阳性预测价值92.9%,阴性预测价值84.4%.结论 基本的临床及实验室资料有助于帮助鉴别结核性脑膜炎和新型隐球菌性脑膜炎,可在实验室条件不够完善的广大基层医院应用.
Objective To create a simple differential diagnostic rule for tuberculous meningitis and cryptococcal meningitis in adults on the basis of basic clinical and laboratory features. Methods We compared the clinical and laboratory features of 219 adults admitted to our hospital during the period of 2000-2008; these patients satisfied the diagnostic criteria for tuberculous meningitis （n=100） and cryptococcal meningitis （n=119）. Multivariate logistic regression analysis was employed to find the risk factors those could independently predict the tuberculous meningitis,so that the diagnostic rule could be created. Results Six risk factors those could independently predict the tuberculous meningitis were found, including gender, mind disorder, vision and/or hearing damage, amount of cerebrospinal fluid protein, total cerebrospinal fluid white-cell count and combination with periphery tuberculosis. A diagnostic rule developed from these features enjoyed a 78.0% sensitivity, a 95.2% specificity, a 92.9% positive predictive value and a 84.4% negative predictive value. Conclusion Simple clinical and laboratory features can help in the differential diagnosis between adult tuberculous meningitis and cryptococcal meningitis, which can be applied in primary hospital with limited microbiological resources.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第9期951-954,共4页
Chinese Journal of Neuromedicine
基金
基金项目：广州市科技计划项目（200723-E0101）
关键词
脑膜炎
结核菌
诊断
Meningitis
Tubercle bacillus
Diagnosis
