Kuzume Daisuke, Morimoto Yuko, Kinboshi Masato, Yoshida Takeshi, Yamasaki Masahiro
Department of Neurology, Chikamori Hospital.
Department of Reumatology, Chikamori Hospital.
Rinsho Shinkeigaku. 2019 Sep 25;59(9):596-599. doi: 10.5692/clinicalneurol.cn-001285. Epub 2019 Aug 30.
The purpose of this study was to elucidate the association between aseptic meningitis and jolt accentuation of headache (JAH) in adults.
87 patients with meningeal irritation (age; 35.6 ± 13.3 years old, 45 males) who were admitted to our hospital from 1st August 2013 to 31st August 2018 were included. The diagnosis was determined according to the following criteria:, aseptic meningitis was defined as cerebrospinal fluids (CSF) pleocytosis with no evidence of bacterial infection, fungal infection or carcinomatous findings; meningism was defined as the absence of CSF pleocytosis. None of these patients had consciousness disturbance and focal neurological abnormalities. The blood and CSF data were reviewed for analysis.
61 patients were in aseptic meningitis group, 26 patients were in meningism group. Multiple logistic regression analysis showed older age (OR 1.059, 95% Confidence interval (CI) 1.012-1.108, P = 0.013), lower CRP (OR 0.803, 95%CI 0.697-0.925, P = 0.002) and absence of JAH (OR 0.048, 95%CI 0.004-0.554, P = 0.015) were significantly associated with aseptic meningitis. The sensitivity and specificity of JAH in aseptic meningitis were 68.9%, 3.8%.
本研究旨在阐明成人无菌性脑膜炎与头痛摇晃加剧（JAH）之间的关联。
纳入2013年8月1日至2018年8月31日期间我院收治的87例有脑膜刺激征的患者（年龄35.6±13.3岁，男性45例）。诊断依据以下标准确定：无菌性脑膜炎定义为脑脊液（CSF）细胞增多且无细菌感染、真菌感染或癌性病变的证据；假性脑膜炎定义为脑脊液无细胞增多。这些患者均无意识障碍和局灶性神经功能异常。回顾血液和脑脊液数据进行分析。
无菌性脑膜炎组61例，假性脑膜炎组26例。多因素logistic回归分析显示，年龄较大（比值比[OR]1.059，95%置信区间[CI]1.012 - 1.108，P = 0.013）、C反应蛋白（CRP）较低（OR 0.803，95%CI 0.697 - 0.925，P = 0.002）以及无JAH（OR 0.048，95%CI 0.004 - 0.554，P = 0.015）与无菌性脑膜炎显著相关。JAH在无菌性脑膜炎中的敏感性和特异性分别为68.9%、3.8%。
