脑脊液LDH、AST、ADA活性和蛋白含量对脑膜炎的诊断意义

Significance of relation between detection of enzyme activity and protein level in CSF and meningitis

目的探讨不同类型脑膜炎时脑脊液酶活性与蛋白含量变化。方法对62例脑膜炎患者脑脊液(CSF)LDH、AST、ADA活性和蛋白含量进行测定。结果结核性脑膜炎组(简称结脑组)、化脓性脑膜炎组(简称化脑组)和病毒性脑膜炎组(简称病脑组)CSF LDH、AST、ADA活性和总蛋白含量较正常对照组明显升高(P<0.05)。结脑组CSF ADA活性升高程度较化脑组和病脑组高(P<0.01)。结脑组和化脑组CSF AST、LDH活性升高程度较病脑组高(P<0.05)。CSF蛋白质含量升高程度化脑组>结脑组>病脑组。结脑组、化脑组和病脑组CSFβ2-MG和CRP较正常对照组均有明显升高,且以病脑组升高最为显著。结论CSF AST、LDH活性有助于细菌性脑膜炎的诊断,CSF ADA活性和蛋白质含量有助于结核性脑膜炎(结脑)、化脓性脑膜炎(化脑)和病毒性脑膜炎(病脑)的鉴别诊断,对CSF的LDH和ADA活性同时测定对结脑的诊断具有重要意义。

Objective To study the variation of enzyme activity and protein level of three type meningitis. Methods Collect CSF of 62 patients and detect the enzyme activity and protein level, agent and equipment were provided by Beckman company. Results The activities of LDH, AST and ADA in CSF of the three meningistis were obviously higher than that of the health control group（P〈0.05）. The activity of ADA in CSF of the tubercular meningitis group was significantly higher than that of the purulent meningitis group and tubercular meningitis group（P〈0.01）. The activities of AST and LDH in CSF of the tubercular meningitis and the purulent meningitis group were higher than that of the virus meningitis（P〈0.05）. The level of total protein increased gently in the virus meningitis,middlely in the tubercular meningitis,and sharply in the purulent meningitis. The levels of CSFβ2-MG and CRP in CSF of the three meningitis were increased obviously than that of the health control group. Moreover, the levels of CSFβ2-MG and CRP were the highest among the three meningitis. Conclusion The activities of AST and LDH in CSF is helpful to the diagnosis of bacterial meningitis, while ADA activity and protein level are helpful to the differential diagnosis of tubercular meningitis.