Cognitive outcome in adults after bacterial meningitis
Cognitive outcome in adults after bacterial meningitis
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DOI：
10.1136/jnnp.2006.110023
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发表时间：
2007-10-01
影响因子：
11
通讯作者：
Schmand, Ben
中科院分区：
文献类型：
--
作者：
Hoogman, Martine;van de Beek, Diederik;Schmand, Ben
目的：方法：对三项前瞻性多中心研究的数据进行汇总和再分析，共涉及155例细菌性脑膜炎成人幸存者（肺炎球菌性脑膜炎后79例，脑膜炎球菌性脑膜炎后76例）和72名健康对照。在32%的患者中发现了认知障碍，这一比例与肺炎球菌和脑膜炎球菌脑膜炎的幸存者相似。肺炎球菌脑膜炎的幸存者在记忆任务中表现较差（p < 0.001），并且往往比脑膜炎球菌脑膜炎的幸存者认知较慢（p = 0.08）。我们发现了一种弥漫性的认知障碍模式，其中认知速度发挥了最重要的作用。认知能力与脑膜炎后的时间无关;然而，脑膜炎后的时间与自我报告的身体损害呈正相关（p< 0.01）。认知功能障碍的频率和数量的异常测试结果的患者，并没有precautive dexamethasone.Conclusions：细菌性脑膜炎的成年幸存者有认知功能障碍的风险，这主要是由认知缓慢。在细菌性脑膜炎后，认知速度的丧失随着时间的推移是稳定的;然而，在细菌性脑膜炎后的几年中，主观身体损害有显着改善。地塞米松的使用与认知障碍无关。
Objective: To evaluate cognitive outcome in adult survivors of bacterial meningitis.Methods: Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis ( 79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls.Results: Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis performed worse on memory tasks (p < 0.001) and tended to be cognitively slower than survivors of meningococcal meningitis ( p = 0.08). We found a diffuse pattern of cognitive impairment in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self- reported physical impairment ( p< 0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar.Conclusions: Adult survivors of bacterial meningitis are at risk of cognitive impairment, which consists mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement in subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment.