儿童病毒性脑炎脑脊液细胞学的早期诊断价值

Early Diagnostic Valve of Cerebrospinal Fluid Cytology with Children Viral Encephalitis

目的探讨脑脊液细胞学(CSFC)检查对儿童病毒性脑炎的早期诊断价值。方法回顾性分析123例病毒性脑炎患儿的临床资料,包括脑电图、头颅CT、脑脊液常规生化和CSFC检查,并对该组资料进行分析比较。结果 123例病毒性脑炎患儿早期症状主要表现为精神差102例(82.9%)、发热80例(65.0%)、头痛79例(64.2%)、呕吐78例(63.4%)、抽搐29例(23.6%)等。脑电图检查异常率为75.6%(93/123),头颅CT检查异常率为21.5%(17/79),脑脊液常规、生化检查异常率为45.5%(56/123),而CSFC检查异常率可达91.1%(112/123),其中以淋巴细胞异常为主(91.1%,102/112)。CSFC和CSF常规生化、脑电图检出结果比较差异有统计学意义(P<0.05)。结论病毒性脑炎早期临床表现多样,在发病早期CSFC检查阳性率较高,对儿童病毒性脑炎的早期诊断有重要价值。

Objective To investigate the value of examination of cerebrospinal fluid cytology（ CSFC ） in earlydiagnosis of children viral encephalitis. Methods Retrospective analysis of 123 patients with viral encephalitis in children with clinical data, ineluding EEG, head CT, cerebrospinal fluid routine and biochemistry and CSFC examination, and data were performed and analyzed. Results The major early clinical symptoms were spirit of the poor in 102 cases （82.9%） , fever in 80 cases （65.0%） , headache in 79 cases（64.2% ） ,nausea and vomiting in 78 cases（63.4% ） ,seizure in 29 cases（23.6% ）. EEG and CT showed abnormality in 75.6% （93/123） and 21.5% （17/79） patients respectively. The abnormal cerebrospinal fluid routine and bio- chemistry was found in 45.5% （56/123） patients. The CSFC was abnormal in 91.1% （112/123） patients mainly with lymphatic cell changes（91. 1% , 102/123 ）. The detection rate of CSFC was higher than that of cerebrospinal fluid routine or EEG（ P 〈 0.05 ）. Conclusion The clinical manifestation was variable in viral encephalitis and CSFC was the most important factor in the early diagnosis of viral encephalitis with the highest abnormality.