摘要：

目的 探讨细菌性脑膜炎并发硬膜下积液的危险因素。方法 回顾性分析细菌性脑膜炎患儿临床资料，Logistic 回归分析探讨硬膜下积液危险因素。结果 硬膜下积液组患儿血清降钙素原（Z = 2.823，P = 0.007）和脑脊液白细胞计数（Z = 3.126，P = 0.003）、蛋白定量（Z = 4.928，P = 0.000）高于对照组、脑脊液葡萄糖低于对照组（t = 2.166，P = 0.033）。经治疗后，硬膜下积液组患儿脑脊液白细胞计数仍高于对照组（Z = 2.467，P = 0.012）、葡萄糖仍低于对照组（t = 4.938，P = 0.000）。Logistic 回归分析显示，血清降钙素原（P = 0.014）和脑脊液白细胞计数（P = 0.027）、蛋白定量（P = 0.002）是细菌性脑膜炎并发硬膜下积液的独立危险因素。结论 细菌性脑膜炎患儿血清降钙素原和脑脊液白细胞计数、蛋白定量显著升高，提示易并发硬膜下积液。

关键词: 脑膜炎, 细菌性, 硬膜下积液, 危险因素, 回归分析, 儿童

Abstract:

Objective  To investigate the risk factors of bacterial meningitis complicated with subdural effusion.  Methods  The clinical data of children with bacterial meningitis in our hospital were collected and analyzed retrospectively. Logistic regression analysis was used to investigate the risk factors for subdural effusion.  Results  A total of 128 cases were divided into control group (N = 64) and subdural effusion group (N = 64). There was no significant difference on serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) between 2 groups (P > 0.05, for all). Compared with control group, cerebrospinal fluid (CSF) WBC (Z = 3.126, P = 0.003), CSF protein (Z = 4.928, P = 0.000) and serum procalcitonin (PCT; Z = 2.823, P = 0.007) in subdural effusion group were significantly higher, while CSF glucose (t = 2.166, P = 0.033) was significantly lower. After treatment, CSF WBC (Z = 2.467, P = 0.012) in subdural effusion group was still significantly higher than that of control group, and CSF glucose (t = 4.938, P = 0.000) was still significantly lower. Logistic regression analysis showed that WBC in CSF (P = 0.027), CSF protein (P = 0.002) and serum PCT (P = 0.014) were independent risk factors for bacterial meningitis complicated with subdural effusion.  Conclusions  CSF examination of children with bacterial meningitis reveals significant increase of CSF WBC, CSF protein and serum PCT, suggesting concurrent subdural effusion is easily occurred.

Key words: Meningitis, bacterial, Subdural effusion, Risk factors, Regression analysis, Children