CAJ | 학술논문

目的：探讨结核性脑膜炎的临床表现和脑脊液细胞学检查对结核性脑膜炎及时诊治的指导意义。方法：回顾性分析38例结核性脑膜炎患者的临床病历资料，尤其是细胞学动态变化资料。结果：38例结核性脑膜炎患者多亚急性起病，以颅高压和脑膜刺激征为主要表现，脑脊液白细胞数、蛋白中度升高，葡萄糖、氯化物中度减低，脑脊液细胞学细胞数多中度升高，早期为混合细胞反应，嗜中性粒细胞比例下降较慢，可稳定在1个月以上，正规抗结核治疗后多数好转，发病2周内接受抗结核治疗的患者预后明显优于其他患者。结论：对于病原学检查阳性率低、早期确诊困难的结核性脑膜炎，脑脊液细胞学检查结合临床症状和其他检查对于其鉴别诊断和治疗评估有重要意义。
목적：탐토결핵성뇌막염적림상표현화뇌척액세포학검사대결핵성뇌막염급시진치적지도의의。방법：회고성분석38례결핵성뇌막염환자적림상병력자료，우기시세포학동태변화자료。결과：38례결핵성뇌막염환자다아급성기병，이로고압화뇌막자격정위주요표현，뇌척액백세포수、단백중도승고，포도당、록화물중도감저，뇌척액세포학세포수다중도승고，조기위혼합세포반응，기중성립세포비례하강교만，가은정재1개월이상，정규항결핵치료후다수호전，발병2주내접수항결핵치료적환자예후명현우우기타환자。결론：대우병원학검사양성솔저、조기학진곤난적결핵성뇌막염，뇌척액세포학검사결합림상증상화기타검사대우기감별진단화치료평고유중요의의。
Objective:To investigate the clinical pictures of tuberculous meningitis ( TBM) and significance of cytological determination of the cerebrospi-nal fluid (CSF) for early diagnosis.Methods:The clinical presentations and cytological features of CSF were reviewed in 38 cases of TBM.Results:Thirty-eight cases were primarily sub-acute onset of TBM,and characterized by intracranial hypertension and meningeal irritation.CSF examination showed moder-ate increase of leukocyte count and protein,yet moderate decrease of glucose and chlorine.In early stage of the disease,CSF was presented with mixed cel-lular response to increased leucocytes.The percentage of neutrophil in CSF was slowly decreased slowly ,and this condition maintained for over one month . After regular anti-tuberculosis medication,37 patients were ameliorated and 1 was dead.Therapy started within 2 weeks after onset had better prognosis than delayed intervention.Conclusion:Cytological CSF examination combined with clinical presentation can be favorable differentiation of TMB for cases with lower positive pathogenic findings that makes hard early diagnosis.