Journal of Hebei Medical University ›› 2021, Vol. 42 ›› Issue (11): 1256-1260.doi: 10.3969/j.issn.1007-3205.2021.11.004

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Exploratory analysis of short-term prognostic risk factors in patients with tuberculous meningitis

  

  1. 1.Department of Neurology, People′s Hospital of Longhua District, Guangdong Province, Shenzhen 
    518109, China; 2.National Clinical Research Center for Infectious Disease, the Second Department of 
    Pulmonary Diseases, the Third People′s Hospital of  Shenzhen City, Guangdong Province, 
    Shenzhen 518112,China; 3.Department of Neurology, the First People′s Hospital of 
    Huizhou City, Guangdong Province, Huizhou 516000, China
  • Online:2021-11-25 Published:2021-11-29

Abstract: Objective To investigate the short-term prognostic risk factors for patients with tuberculous meningitis(TBM). 
Methods Designed as a retrospective study, this study included a total of 310 patients with TBM. The outcome indicators for short-term prognosis were defined as the disease status(improvement or death) when the patients were discharged from the hospital. Additionally, the univariate and multivariate binary Logistic regression analyses were performed including the baseline characteristics, laboratory examination, neuroimaging examination and other factors to identify the risk factors that might contribute to the short-term prognostic risk factors for patients with TBM. 
Results The incidence of consciousness disturbance, positive Kremer′s sign and positive pyramidal tract sign were higher in death group than those in disease improvement group(P<0.05). The white blood cell(WBC) count of peripheral blood in death group was higher than that in disease improvement group, and the percentage of peripheral blood lymphocytes was significantly lower than that in the disease improvement group(P<0.05). The incidence of color(light yellow, yellow or cloudy) of cerebrospinal fluid in death group was higher than that in disease improvement group(P<0.05). And the incidence of positive hydrocephalus in death group was higher than that in disease improvement group, and the incidence of positive cerebral tuberculoma was lower than that in disease improvement group(P<0.05).  Results of multivariate analysis suggested that the WBC counts, percentage of peripheral blood lymphocytes  and blood glucose at admission were independent risk factors for the short-term prognosis of patients with TBM(P<0.05). 
Conclusion Elevated WBC counts, decreased  percentage of peripheral blood lymphocytes and elevated blood glucose at admission TBM patients are associated with relatively worse short-term prognosis. 


Key words: tuberculosis, meningeal, clinical symptoms, short-term prognosis