脑脊液酶谱对小儿不典型细菌性脑膜炎诊断意义的临床研究

Diagnostic significance of cerebrospinal fluid zymogram on child atypical bacterial meningitis

目的探讨脑脊液酶谱的变化对小儿不典型细菌性脑膜炎的诊断意义。方法根据脑脊液(CSF)细菌学检查和病毒特异性IgM抗体测定的结果,将126例脑膜炎患者分为小儿不典型细菌性脑膜炎组和病毒性脑膜炎组,分别对其CSF进行酶谱检测。同时,选取30例正常脑脊液作为对照。结果小儿不典型细菌性脑膜炎组患者CSF中AST、ALT、γ～GT、ALP、LDH、CK～BB、NSE的含量显著高于病毒性脑膜炎组和正常对照组,组间差异有极显著意义(P<0.01)。结论小儿不典型细菌性脑膜炎患者CSF的酶谱呈相对特异性的变化,有助于临床对细菌性脑膜炎的诊断和鉴别诊断。

Objective To probe the diagnostic significance of the changes of cerebrospinal fluid zymogram in child atypical bacterial meningitis （CABM）. Methods Based on the results of bacteriological test of cerebrospinal fluid （CSF） and measurement of virus specific IgM antibodies, 126 infants with meningitis were divided into CABM group and virus meningitis （VM） group. AST, ALT, γ-GT, ALP, LDH, CK-BB and NSE in their CSF were examined. In the meantime, CSF samples collected from 30 infants with acute appendicitis during operative anesthesia was used as the control. Results The levels of AST, ALT, γ-GT, ALP, LDH, CK-BB and NSE of CSF in the CABM group was 57.2±13.8U/L, 26.7±11.7U/L, 13.7±1.2U/L, 32.9±13.6U/L, 90.9±31.4U/L, 13.3±4.0U/L and 35.8±14.4ng/ml respectively, which was remarkably higher than those both the VM group and the control group. The resuits between the CABM and the control groups showed significantly different （P〈0.01）. Conclusions The zymogram of CSF in patients with CABM presents a relatively specific change, which can conduce to the differential diagnosis of bacterial meningitis.