结核性脑膜炎患者脑脊液中腺苷脱氨酶和结核抗体水平研究

The level of ADA and PPD-IgG in CSFs of patients with tuberculous meningitis

目的探讨结核性脑膜炎(TBM)的早期诊断方法。方法采用氨的偶联酶测定法和酶联免疫吸附实验(ELISA)检测3组病例(结脑组51例,病脑组30例,非脑膜炎组20例)脑脊液(CSF)中腺苷脱氨酶(ADA)的活性水平和脑脊液结核抗体(PPD-IgG)的阳性率。结果研究发现结脑组脑脊液中腺苷脱氨酶活性水平明显升高,与病脑组和非脑膜炎组比较有显著性差异(P<0.01)。而病脑组与非脑膜炎组比较无显著性差异(P>0.05);结核性脑膜炎早期脑脊液中结核抗体的阳性率为80.4%(其中2周内PPD-IgG阳性率为80.4%,1周内为23.5%,其他为3.9%),在随后的临床跟踪检测中为100%。结论说明共同检测脑脊液中腺苷脱氨酶的活性明显升高和结核抗体阳性可以作为结脑早期诊断的重要依据。

Objective To explore the method to diagnose tuberculous meningitis （TBM） at earlier period. Methods The level of ADA and anti-TB antibodies in cerebrospinal fluid （CSF） of patients with TBM was determined by the biochemical methods and ELISA. Results The level of ADA in CSF of all patients suffering from TBM increased markedly compared with those from the patients with viral meningitis （ P 〈 0.05） and the normal （P 〈 0.01）. The positive ratio of anti-TB antibody was 80.4% in the early stage of diseases, and 100% at the following clinical observation, but negative in all patients with viral meningitis and all normal controls. Conclusion The elevation of ADA level and the positive PPD-IgG in CSF of patients might be helpful to diagnose TBM.