急性布鲁氏菌病并发中枢神经损害患者临床特征分析

目的分析布鲁氏菌病中枢神经损害脑脊液特征,探讨其临床诊断价值。方法选择2007年至2014年黑龙江省农垦总局总医院住院治疗的急性布鲁氏菌病并发中枢神经损害患者20例作为观察对象。临床诊断:并发脑膜炎8例、脑膜脑炎3例、脊髓炎7例和脑脓肿2例。调查其住院病例资料,观察脑脊液常规检查各项指标,分析和评估脑脊液改变特点。结果脑脊液异常改变,颅内压增高13例,白细胞计数增多18例(90.00%),蛋白增高19例(95.00%),葡萄糖和氯化物降低16例(80.00%)。结论布鲁氏菌病并发中枢神经损害患者脑脊液多发生异常改变,颅内压升高,白细胞计数增多,葡萄糖和氯化物降低为特征,诊断需要与结核性脑膜炎相鉴别。

Clinical characteristics of acute brucellosis complicated with central nervous system damage

To analyze the characteristics of cerebrospinal fluid in the central nerve of brucellosis and to explore its clinical diagnostic value, twenty patients with acute brucellosis complicated with central nervous system injury who were hospitalized in the General Hospital of Heilongjiang Land Reclamation Bureau from 2007 to 2014 were selected as observation objects. Eight clinical cases of complicated meningitis were diagnosed, meningoencephalitis in 3 cases, myelitis in 7 cases, and brain abscess in 2 cases. We investigated the data of its inpatients, observed the indicators of routine cerebrospinal fluid examination, analyzed and evaluated the characteristics of changes in cerebrospinal fluid. Results showed that abnormal cerebrospinal fluid changes, intracranial pressure increased in 13 cases, white blood cell count increased in 18 cases (90.00%), protein increased in 19 cases (95.00%), glucose and chloride decreased in 16 cases (80.00%). The cerebrospinal fluid in patients with brucellosis complicating with central nervous system injury has abnormal changes, increasing intracranial pressure, increasing white blood cell count, and decreased glucose and chloride levels. The diagnosis needs to be differentiated from tuberculosis meningitis.