结核性脑膜脑炎脑脊液细胞学动态分析及其诊断价值

Cytological features of cerebrospinal fluid and its value on diagnosis of tuberculous meningitis

目的探讨脑脊液细胞学特点在结核性脑膜脑炎临床诊断中的价值。方法运用玻片细胞沉淀(粟秀初教授研制)细胞学方法,对72例结核性脑膜脑炎患者的脑脊液细胞学分类特点进行动态观察与分析,以评估治疗效果。结果结核性脑膜脑炎患者脑脊液白细胞总数升高。早期嗜中性粒细胞增高,随后呈混合型细胞反应,随着病情的好转,嗜中性粒细胞逐渐消失,以淋巴、单核细胞为主。结论脑脊液细胞学检查操作简便,结果确切,有一定特异性,对结核性脑膜脑炎的临床诊断具有辅助价值。

Objective To investigate the cytological features of the cerebrospinal fluid in the clinical diagnosis of the tuberculous meningitis （TBM）. Methods By using the eerebrospiual fluid sediment chamber method, curative effects of 72 cases of TBM were evaluated through the dynamic observation and analysis on the cytological features of cerebrospinal fluid. Results The total leucocytes increased in CSF of TBM patients. In the initial stage the granulocytes increased obviously followed by mixed cell reaction. The neutrophilic granulocytes disappeared gradually over time with the occurrence of lymphocytes and monocytes. Conclusion The cytological aualysis of cerebrospinal fluid plays a subsidiary role in the diagnosis of the tuberculous meningitis （TBM） because of its convenience, preciseness and specificity.