成人病毒性脑膜炎62例临床分析

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.

Analysis of 62 adult patients with viral meningitis

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.