2005年春季广州市流行性脑脊髓膜炎患者实验室检查特点

Laboratory examination results of 41 patients with epidemic cerebrospinal meningitis in Guangzhou in 2005

目的探讨流行性脑脊髓膜炎(简称流脑)患者实验室检查的特点。方法分析2005年春季本院收治的41例确诊流脑患者的实验室检查结果。结果41例流脑患者外周血象白细胞及中性粒细胞显著升高,并在病程第3天达高峰,随后迅速下降,多在一周内恢复正常。血小板下降,其中血小板容积比下降明显。脑脊液白细胞及中性粒细胞亦显著升高,进入病程第2周后恢复。血清LDH、CK、CK-MB、ALT、AST等有不同程度的异常,分别为6例(14·63%)、14例(34·15%)、19例(46·34%)、16例(39·02%)、18例(43·90%),治疗后逐渐恢复。脑膜炎奈瑟氏菌(Nm)检出率为60·98%(25/41),病原菌对青霉素、氯霉素、复方磺胺及头孢曲松均敏感,部分对庆大霉素、红霉素耐药。结论患者临床表现及白细胞计数、脑脊液检查结果典型,部分患者生化结果异常,血小板容积比明显下降。早诊断、早治疗有助于患者预后且病原体检出率高,常用抗生素敏感。

Objective To study the laboratory examination result of epidemic cerebrospinal meningitis. Methods The laboratory results of 41 patients with epidemic cerebrospinal meningitis were analyzed, who were admitted to our hospital in the spring of 2005. Results The white blood cell counts and leucocyte of peripheral blood were increased significantly, peaked on the third day of the disease, then decreased quickly, and return to normal within one week. The blood platelet decreased, and cubage ratio decreased significantly. The white blood cell counts and leucocyte of cerebrospinal fluid increased significantly and returned to normal within two weeks. Six patients （14.63%） had abnormal serum LDH, 14 （34.15%） had abnormal CK, 19 （46.34%） had abnormal CK-MB, 16 （39.02%） had abnormal ALT, 18 （43.90%） had abnormal AST, and these indexes returned to normal after treatment. The positive detecting rate of neisseria meningitides was 60.98%. The pathogen was sensitive to penicillin, chloramphenicol, compound sulfanomides and cefirixone. Conclusion The clinical manifestation and laboratory examination results of WBC and cerebrospinal fluid were typical. Part patients had abnormal biochemical examination results. The cubage ratio of blood platelet decreased significantly. The good prognosis ,was highly due to early diagnosis and treatment.