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目的 分析 6 3例囊虫性脑膜炎的临床资料 ,以加强对此病的认识 ,提高临床医师对此病的诊断率。方法 选取囊虫性脑膜炎患者 6 3例 ,对其起病形式、临床症状与体征、辅助检查等进行分析。结果 患者多生活在囊虫病高发地区 (95 % ) ;慢性或亚急性起病 (95 % ) ;表现为反复发作性头痛 (6 0 % ) ,可伴有发热(2 7% )或痴呆 (15 % ) ,脑膜刺激征阳性 (6 3% ) ;血嗜酸性细胞增加 (5 0 % ) ;CSF以淋巴细胞为主 (47% ) ,蛋白可升高 ,囊虫抗体阳性 ;皮下结节活检被证实为囊虫 ;非脑囊虫病的典型影像学表现 ,可伴有脑积水 (49% )。结论 囊虫性脑膜炎是一种少见浆液性脑膜炎 ,应与结核性脑膜炎、霉菌性脑膜炎、梅毒性脑膜炎及原发或继发的脑膜癌变等鉴别。
Objective To analyze the clinical data of 63 cases of cysticercosis meningitis in order to enhance the understanding of the disease and improve the diagnosis rate of clinicians. Methods Sixty three patients with cysticercosis meningitis were selected for analysis of their forms of onset, clinical symptoms and signs, and auxiliary examinations. Results Most of the patients were living with cysticercosis (95%), chronic or subacute onset (95%), recurrent headache (60%), fever (27%) or dementia 15%), positive meningeal irritation (63%), blood eosinophilia (50%), predominantly lymphocyte (47%), elevated protein and positive cysticercosis antibody. Subcutaneous nodules biopsy Confirmed as cysticercosis; non-cerebral cysticercosis typical imaging findings may be associated with hydrocephalus (49%). Conclusion Cysticercus meningitis is a rare serous meningitis that should be distinguished from tuberculous meningitis, fungal meningitis, syphilitic meningitis and primary or secondary meningeal carcinomatosis.