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足月儿与早产儿细菌性脑膜炎的临床分析
A clinical analysis of bacterial meningitis in full-term and preterm infants
目的 探讨足月儿和早产儿细菌性脑膜炎的临床特征及转归特点。方法 回顾性分析102例新生儿细菌性脑膜炎患儿的临床资料，根据胎龄分为早产儿组（n=46）及足月儿组（n=56），比较两组患儿临床表现、实验室结果、影像学结果及临床转归。结果 早产儿组临床表现主要为反应差和呼吸暂停/急促（P < 0.05），足月儿组则以发热及抽搐多见（P < 0.05）。足月儿组脑脊液糖高于早产儿组（P < 0.05），早产儿组C-反应蛋白、血培养阳性率及不良预后发生率高于足月儿组（P < 0.05）。两组外周血白细胞计数、脑脊液白细胞、脑脊液蛋白及脑脊液培养阳性率差异无统计学意义（P > 0.05）。结论 早产儿及足月儿细菌性脑膜炎临床表现有所不同，早产儿组不良预后发生率更高。
Objective To study the clinical features and prognosis of bacterial meningitis in full-term and preterm infants. Methods A retrospective analysis was performed for the clinical data of 102 neonates with bacterial meningitis. According to the gestational age, they were divided into a preterm group (n=46) and a full-term group (n=56). The two groups were compared in terms of clinical manifestations, laboratory markers, imaging findings, and clinical outcomes. Results Poor response and apnea were the major clinical manifestations in the preterm group (P < 0.05), while pyrexia and convulsions were more common in the full-term group (P < 0.05). The full-term group had a significantly higher glucose level in cerebrospinal fluid (CSF) than the preterm group (P < 0.05). Compared with the full-term group, the preterm group had significantly higher C-reactive protein level, positive rate of blood culture, and incidence rate of poor prognosis (P < 0.05). There were no significant differences between the two groups in leukocyte count in peripheral blood, levels of leukocytes and protein in CSF, and positive rate of CSF culture (P > 0.05). Conclusions There are certain differences in the clinical manifestations between full-term and preterm infants with bacterial meningitis. Preterm infants tend to have a higher incidence rate of poor prognosis.
细菌性脑膜炎 / 临床特征 / 转归 / 足月儿 / 早产儿
Bacterial meningitis / Clinical feature / Prognosis / Full-term infant / Preterm infant
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陕西省卫生计生科研基金项目（2016B007）；陕西省科技厅重点研发项目（2018SF-070）。
