Shaikh Mumtaz Ali, Shah Mujtaba, Channa Faraz
Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Sindh.
J Pak Med Assoc. 2012 Nov;62(11):1137-9.
To work out a criterion that may indicate morbidity in tuberculous meningitis.
The retrospective study was conducted at the Medical Unit of the Liaquat University of Health Sciences, Jamshoro, Pakistan, and included cases related to a period between January 2006 and June 2011. Record of 50 patients were evaluated for clinical features, chest radiograph, Mantoux test, sputum for acid fast bacilli, routine investigations, cerebrospinal fluid studies, computerised tomography scan and magnetic resonance imaging of head. All the patients in the study had been treated with conventional approach. The severity of the condition was classified in stages, I, II and III. Clinical features, laboratory findings and imaging reports were analysed through SPSS 10 to find out the criteria indicating morbidity. Mean, median, standard deviation were calculated. Student t-test was applied on variables.
Of the 50 patients, 26 (52%) were male and 24 (48%) were female. Their ages ranged from 12 to 70 years. Mean age was 37.72 +/-19.65 years. Median age was 35.54 years. Of the total, 17 (34%) patients recovered completely without any complications. Their mean age was 24+/-8.98 years and their mean time interval from onset of illness to presentation in the hospital was 21.75+/-9.75 days. Besides, 30 (60%) patients persisted with neurological sequelae, including cranial nerve palsies, hemiplegia, and hydrocephalus. Patients with neurological sequelae had mean age of 48+/-17.48 years and their mean time interval from onset of illness to presentation in the hospital was 41.33+/-14.14 days. Hydrocephalus was seen in 10 (20%) patients. Three (6%) patients expired. Clinical features, laboratory findings and imaging reports analysis showed that the criteria indicating morbidity were increasing age of the patient (p=0.037), late diagnosis (p=0.044), advancing stage of disease, and development of hydrocephalus.
Increasing age of the patient, late diagnosis, advancing stage of the disease and the development of hydrocephalus indicate morbidity in tuberculous meningitis.
制定一个可提示结核性脑膜炎发病情况的标准。
在巴基斯坦詹姆肖罗利亚卡特健康科学大学医学科进行回顾性研究，纳入2006年1月至2011年6月期间的病例。对50例患者的记录进行评估，内容包括临床特征、胸部X线片、结核菌素试验、痰涂片找抗酸杆菌、常规检查、脑脊液检查、头颅计算机断层扫描及磁共振成像。研究中的所有患者均采用传统方法治疗。病情严重程度分为I、II和III期。通过SPSS 10分析临床特征、实验室检查结果及影像学报告，以找出提示发病情况的标准。计算均值、中位数、标准差。对变量应用学生t检验。
50例患者中，26例（52%）为男性，24例（48%）为女性。年龄范围为12至70岁。平均年龄为37.72±19.65岁。中位数年龄为35.54岁。其中，17例（34%）患者完全康复且无任何并发症。他们的平均年龄为24±8.98岁，从发病到入院的平均时间间隔为21.75±9.75天。此外，30例（60%）患者遗留神经后遗症，包括脑神经麻痹、偏瘫和脑积水。有神经后遗症的患者平均年龄为48±17.48岁，从发病到入院的平均时间间隔为41.33±14.14天。10例（20%）患者出现脑积水。3例（6%）患者死亡。临床特征、实验室检查结果及影像学报告分析显示，提示发病情况的标准为患者年龄增加（p=0.037）、诊断延迟（p=0.044）、疾病进展期及脑积水的发生。
患者年龄增加、诊断延迟、疾病进展期及脑积水的发生提示结核性脑膜炎的发病情况。
