老年结核性脑膜炎27例脑脊液细胞学动态分析

Dynamic analysis of cerebrospinal fluid cytology from 27 elderly tuberculous meningitis patients

目的了解老年结核性脑膜炎患者急性期和恢复期脑脊液(CSF)细胞学变化特点和应用价值。方法 27例老年结核性脑膜炎病人经临床和辅助检查确诊,所获脑脊液采用自然沉淀法收集细胞,经MGG染色后光学显微镜下行细胞分类计数。结果 53份CSF标本有3份结果阴性(5.6%),余50份CSF细胞学均有异常。急性发病期CSF白细胞多以免疫活性细胞为主,其中转化型淋巴细胞出现率最高(83.33%),恢复期吞噬细胞出现率上升明显,达到65.38%。急性和恢复期均以转化型淋巴细胞反应为主的混合型细胞反应占优势。结论 CSF细胞学可协助早期诊断老年结核性脑膜炎,并对病程监测,预后评估提供帮助。

Objective To discuss the characteristics of cerebrospinal fluid（CSF）cytology of elderly tuberculous meningitis at the acute stage or in the convalescent period of this disease.Methods All of the patients had been diagnosed as elderly tuberculous meningitis by clinical manifestations and laboratory examinations.The cerebrospinal fluid was obtained by routine way,next the acquired cells were stained by MGG.Results 3 CSF samples turned out to be normal（5.6%）,and the others＇ results of cerebrospinal fluid cytology were abnormal.At the acute onset,immunologically competent cells were usually seen in CSF from the patients of elderly tuberculous meningitis,and the frequency of transformant lymphocyte was the highed（83.33%）.During the convalescent period,the rate of phagocyte began to rise（65.38%）.Mixed lymphocyte reactions predominated in the whole course of disease.Conclusion Cerebrospinal fluid cytology examination could assist the early diagnosis of elderly tuberculous meningitis,and it would do much for disease monitoring and prognosis assessment.