| 结核性脑膜炎临床诊断的分析 |
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| 引用本文： | 常晓琳,张敏,杨毅宁,代文,粟秀初,赵钢. 结核性脑膜炎临床诊断的分析[J]. 医学争鸣, 2009, 30(8): 704-706 |
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| 作者姓名： | 常晓琳 张敏 杨毅宁 代文 粟秀初 赵钢 |
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| 作者单位： | 第四军医大学西京医院神经内科,陕西,西安,710033;解放军第518医院,陕西,西安,710043;第四军医大学西京医院神经内科,陕西,西安,710033;南京军区福州总医院神经内科,福建,福州,350023;第四军医大学西京医院神经内科,陕西,西安,710033 |
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| 摘 要： | 目的:探讨结核性脑膜炎(TBM)的临床诊断.方法:对45例IBM和40例病毒性脑炎(病脑)患者的临床症状及辅助检查资料进行回顾性分析.结果:颅神经损害在TBM组发生率较高(P<0.05),发热、头痛、呕吐、精神异常、意识障碍、脑膜刺激征及颅内压等两组间无差别.TBM组结核菌素试验阳性率显著高于病脑组(P<0.05),而血沉无明显差异.TBM组EEG、头颅CT及MRI表现异常亦均高于病脑组(P<0.05).TBM组脑脊液的蛋白、免疫球蛋白IgG和IgM高于病脑组(P<0.05),而氯化物低于病脑组,葡萄糖及免疫球蛋白IgA两组之间无差别.TBM组脑脊液的中性粒细胞百分率、混合型细胞反应均高于病脑组,而淋巴样细胞反应低于病脑组(P<0.05).结论:综合分析患者的临床表现和实验室尤其是脑脊液细胞学检查结果,对TBM的诊断能起到非常重要的作用.
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| 关 键 词： | 结核 脑膜 诊断 鉴别 脑脊髓液/细胞学 |
An analysis of clinical diagnoses of tuberculous meningitis |
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| CHANG Xiao-Lin,ZHANG Min,YANG Yi-Ning,DAI Wen,SU Xiu-Chu,ZHAO Gang. An analysis of clinical diagnoses of tuberculous meningitis[J]. Negative, 2009, 30(8): 704-706 |
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| Authors: | CHANG Xiao-Lin ZHANG Min YANG Yi-Ning DAI Wen SU Xiu-Chu ZHAO Gang |
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| Affiliation: | CHANG Xiao-Lin1,2,ZHANG Min1,3,YANG Yi-Ning1,DAI Wen1,SU Xiu-Chu1,ZHAO Gang11Department of Neurology,Xijing Hospital,Fourth Military Medical University,Xi'an 710033,China,2PLA 518 Hospital,Xi'an 710043,3Department of Neurology,PLA Fuzhou General Hospital,Nanjing Military Area Command,Fuzhou 350023 |
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| Abstract: | AIM:To analyze the clinical diagnoses of tuberculous meningitis. METHODS:Clinical symptoms and auxiliary examinations of 45 patients with tuberculous meningitis and 40 patients with virus meningitis were analyzed retrospectively. RESULTS:The cranial nervous lesions were more common in patients with tuberculous meningitis than patients with virus meningitis (P<0.05)but no significant differences was seen in fever,headache,vomiting,emotional disturbance,conscious disturbance,meningeal irritation sign and intr... |
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| Keywords: | tuberculosis meningeal diagnosis differential cerebrospinal fluid/cytology |
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