结核伴蛛网膜炎患者的临床概况、结局和预后预测因素。

IF 1.6 Q4 INFECTIOUS DISEASES
International Journal of Mycobacteriology Pub Date : 2025-04-01 Epub Date: 2025-06-20 DOI:10.4103/ijmy.ijmy_29_25
David Mathew Daniel, Samuel George Hansdak, Tina George, Sheba Mariam Thomas, Amith Balachandran, Harshad Arvind Vanjare, Prasanna Samuel, Ramya Iyadurai
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引用次数: 0

摘要

背景:结核病(TB)仍然是全球传染病相关死亡的主要原因。本研究旨在探讨结核性蛛网膜炎患者的临床特征、预后及预后因素。结核性蛛网膜炎是结核的一种严重并发症,影响脊髓和神经根。方法:回顾性分析2011年7月至2021年11月在三级保健中心收治的结核性蛛网膜炎成年患者。共纳入119例患者。收集的数据包括人口统计学、临床表现、脑脊液(CSF)分析、治疗方案以及在就诊和随访时使用改良兰金量表评估的结果。结果的预测因子,包括死亡率,使用SPSS软件进行分析。结果:患者年龄中位数为34岁(标准差±14.13),男女比例为53:47。常见的表现包括下肢无力(67%,功率≤3/5)和肠/膀胱功能障碍(61%)。较高的脑脊液白细胞计数和人类免疫缺陷病毒(HIV)合并感染与较差的预后显著相关;63.6%的hiv阳性患者在复查前死亡。脑脊液蛋白水平升高与死亡率直接相关。抗结核治疗(ATT)持续时间越长,预后越好。统计分析确定HIV状态和CSF蛋白计数是结核蛛网膜炎死亡率的独立预测因子。结论:在这组结核性蛛网膜炎患者中,下肢无力和肠/膀胱失禁是主要的临床特征。HIV血清阳性、CSF蛋白水平升高和ATT持续时间显著影响患者预后。这些发现强调了早期诊断、及时开始ATT治疗和管理艾滋病毒等相关因素对改善结核蛛网膜炎患者预后的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Profile, Outcomes, and Predictors of Outcomes in Patients with Tuberculosis with Arachnoiditis.

Background: Tuberculosis (TB) remains a leading global cause of infectious disease-related mortality. This study aimed to investigate the clinical characteristics, outcomes, and prognostic factors in patients diagnosed with tuberculous arachnoiditis, a serious complication of TB affecting the spinal cord and nerve roots.

Methods: This is a retrospective analysis of adult patients admitted with tuberculous arachnoiditis to a tertiary care center between July 2011 and November 2021. A total of 119 patients were included. Data collected included demographics, clinical presentation, cerebrospinal fluid (CSF) analysis, treatment regimens, and outcomes assessed using the Modified Rankin Scale at presentation and follow-up. Predictors of outcomes, including mortality, were analyzed using SPSS software.

Results: The median age of patients was 34 years (standard deviation ± 14.13), with a male-to-female ratio of 53:47. Common presenting features included lower-limb weakness (67% with power ≤3/5) and bowel/bladder dysfunction (61%). Higher CSF leukocyte counts and human immunodeficiency virus (HIV) co-infection were significantly associated with worse outcomes; 63.6% of HIV-positive patients died before review. Elevated CSF protein levels were directly correlated with mortality. Longer duration of antitubercular therapy (ATT) was associated with improved outcomes. Statistical analysis identified HIV status and CSF protein count as independent predictors of mortality in TB arachnoiditis.

Conclusion: In this cohort of patients with tuberculous arachnoiditis, lower-limb weakness and bowel/bladder incontinence were the predominant clinical features. HIV seropositivity, elevated CSF protein levels, and duration of ATT significantly influenced patient outcomes. These findings underscore the importance of early diagnosis, prompt initiation of ATT, and management of associated factors like HIV in improving outcomes for patients with TB arachnoiditis.

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来源期刊
CiteScore
2.20
自引率
25.00%
发文量
62
审稿时长
7 weeks
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