新发传染病电子杂志2025，Vol.10Issue(6)：63-69,7.DOI:10.19871/j.cnki.xfcrbzz.2025.06.010
结核性脑膜炎患者脑脊液乳酸水平与颅脑MRI表现及预后的关系
Relationship between cerebrospinal fluid lactate level and craniocerebral MRI findings and prognosis of tuberculous meningitis
摘要
Abstract
Objective To explore the correlation between lactate level of cerebrospinal fluid(CSF)and cranial magnetic resonance imaging(MRI)manifestations and prognosis of tuberculous meningitis(TBM)patients,so as to provide a basis for diagnosis and prognosis of TBM.Method This study adopted a retrospective analysis method.A total of 48 patients with TBM admitted to Chongqing Dazu District People's Hospital from January 2020 to February 2023 were included and followed up for 6 months.The adverse clinical outcome was death or severe disability 6 months after admission.Patients with death or severe disability were included in the adverse outcome group(n=16),and patients with a Glasgow outcome scale(GOS)of 4 or 5 were included in the good outcome group(n=32).All patients underwent MRI examination,and CSF lactate levels were analyzed by automatic biochemical analyzer.Result Compared with the good outcome group,the CSF lactate level in the bad outcome group was significantly higher[(4.07±2.42)mmol/L vs(6.59±3.44)mmol/L,t=2.946,P=0.005].Receiver operating characteristic curve analysis showed that CSF lactate level predicted 6-month clinical outcome of TBM patients with an area under the curve of 0.838(95%CI:0.688-0.988)at the optimal cut-off value(4.36 mmol/L),the sensitivity and specificity of the prediction were 87.5%and 84.4%,respectively.Multivariate Logistics analysis determined that CSF lactate level＞4.36 mmol/L was an independent risk factor for death in TBM patients within 6 months.TBM patients with CSF lactate level＞4.36 mmol/L were more likely to have MRI findings of basal ganglia region,thalamus,cerebellum cerebral infarction and hydrocephalus(P＜0.05).Conclusion TBM patients with a CSF lactate level＞4.36 mmol/L of admission are more likely to present with cerebral infarction and hydrocephalus findings on MRI.This indicator is also an independent risk factor for mortality within 6 months in TBM patients,and serves as an important indicator for assessing the prognosis of TBM patients.关键词
脑脊液乳酸/结核性脑膜炎/磁共振成像/影像学表现/预后Key words
Cerebrospinal fluid lactate/Tuberculous meningitis/Magnetic resonance imaging/Imaging manifestations/Prognosis分类
医药卫生引用本文复制引用
黄志强,吴绍全,周帮建,田永攀,吴继祥,彭云航..结核性脑膜炎患者脑脊液乳酸水平与颅脑MRI表现及预后的关系[J].新发传染病电子杂志,2025,10(6):63-69,7.基金项目
重庆市卫生健康委医学科研计划资助项目(2021-2-213) （2021-2-213）
