CAJ | 학술논문

目的探讨成人病毒性脑膜炎的临床特征、脑脊液以及辅助检查特点.方法回顾性分析62例成人病毒性脑膜炎的临床资料.结果 62例(100%)患者均有头痛症状,61例(98%)有发热,48例(77%)有脑膜刺激征,1例患者出现左眼外展受限,2例患者出现癫痫发作.平均病程17 d,93%的患者病程短于30 d.80%的患者脑脊液初压增高,91%的患者白细胞数量增多.81%的患者蛋白含量增高,35%的患者氯化物在正常范围,65%的患者氯化物稍低,均高于110 mmol/L,94%的患者糖含量在正常范围.7例患者脑脊液以及血液柯萨奇病毒B组IgM抗体阳性,1例脑脊液EB病毒IgM抗体阳性.62例患者脑CT均无特异性发现,23例行脑磁共振血管造影术(MRI)检查的患者中,有9例可见脑膜强化,强化部位多位于大脑半球.52%的患者存在脑电图异常,主要表现为局部或散在慢波增多.结论成人病毒性脑膜炎是一种自限性疾病,半数以上患者脑脊液氯化物稍低,部分患者脑MRI可见脑膜强化.
목적 탐토성인병독성뇌막염적림상특정、뇌척액이급보조검사특점.방법 회고성분석62례성인병독성뇌막염적림상자료.결과 62례(100%)환자균유두통증상,61례(98%)유발열,48례(77%)유뇌막자격정,1례환자출현좌안외전수한,2례환자출현전간발작.평균병정17 d,93%적환자병정단우30 d.80%적환자뇌척액초압증고,91%적환자백세포수량증다.81%적환자단백함량증고,35%적환자록화물재정상범위,65%적환자록화물초저,균고우110 mmol/L,94%적환자당함량재정상범위.7례환자뇌척액이급혈액가살기병독B조IgM항체양성,1례뇌척액EB병독IgM항체양성.62례환자뇌CT균무특이성발현,23례행뇌자공진혈관조영술(MRI)검사적환자중,유9례가견뇌막강화,강화부위다위우대뇌반구.52%적환자존재뇌전도이상,주요표현위국부혹산재만파증다.결론 성인병독성뇌막염시일충자한성질병,반수이상환자뇌척액록화물초저,부분환자뇌MRI가견뇌막강화.
Objective To investigate the clinical manifestation, cerebruspinal fluid(CSF) and auxiliary examination findings of adult viral meningitis. Methods 62 adult patients with viral meningitis were retrospectively analyzed. Results Headache occurred in all the 62(100%) patients, fever occurred in 61 (98%) patients, meningeal irritation sign occurred in 48 (77%) patients. The abduction of left eye was limited in one patient. Seizure occurred in 2 patients. The mean duration time was 17 days, 93% patients less than 30 days. The pressure of CSF increased in 80% patients, leukocyte counts increased in 91% patients, protein level increased in 81% patients, chloride level was normal in 35% patients and sfighfly lower in 65% patients, glucose level was normal in 94% patients. 7 patients had positive IgM antibody of Coxackievirus B group both in serum and CSF,one patient had positive IgM antibody of EB virus in CSF. Cranial CT scan had no special findings in all patients.23 patients performed MRI examination, meningeal enhancement occurred in 9 patients. 52% patients had abnormal EEG, mainly increased local or diffuse slow waves. Conclusion Adult viral meningitis was a kind of selflimited disease, chloride level was shghtly lower in more than half patients, meningeal enhancement was detected in MRI in part patients.