中枢神经系统感染脑脊液乳酸测定的意义

Detection of content of cerebrospinal fluid lactic acid in identifying the infection of central nervous system

目的 :通过检测中枢神经系统 (CNS)感染患者脑脊液乳酸 (CSF LA)含量 ,以鉴别病毒性脑膜炎 (病脑 )、化脓性脑膜炎(化脑 )、结核性脑膜炎 (结脑 )。方法 :采用硫酸铜法 ,72 1分光光度计检测乳酸含量。结果 :正常对照组CSF LA含量为 16 .0±3.6mg % ,病脑组 17.2± 4.2mg % ,化脑组 6 0 .8± 12 .6mg % ,结脑组 5 1.5± 12 .9mg% ,脑囊尾蚴病组 17.7± 5 .4mg% ,化脑组和结脑组明显高于其他 3组 (P <0 .0 1) ,但两组间差异无显著性 (P >0 .0 5 )。通过CSF LA动态观察 ,化脑组CSF LA降至正常值(30mg % )以下需要 8.0± 2 .7天 ,结脑组需 2 1± 6 .3天 ,明显长于化脑组 (P <0 .0 1)。结论 :化脑组和结脑组CSF LA含量均显著高于正常对照组、病脑组和脑囊尾蚴病组 ;结脑组CSF LA恢复至正常值所需天数明显长于化脑组。

Objective:To identify viral meningitis,purulent meningitis and tuberculous meningitis by detecting the content of cerebrospinal fluid lactic acid(CSF LA) in patients with infections of central nervous system.Methods:The value of lactic acid was detected by using copper sulphate.Results:The content of CSF LA was 16.0±3.6 mg% in normal control group,17.2±4.2 mg% in viral meningitis group,60.8±12.6 mg% in purulent meningitis group,51.5±12.9 mg% in tuberculous meningitis group and 17.7±5.4 mg% in cysticercosis group.The contents of CSF LA in purulent meningitis and tuberculous meningitis groups were significantly higher than those in the other three groups( P <0.01).But there was no significant difference between the two groups( P >0.05).By dynamic detection of CSF LA,we could see that in purulent meningitis group it took 8.0±2.7 days of CSF LA to lower to normal level (30 mg%),whereas in tuberculous meningitis group it took 21±6.3 days,which was remarkably longer than that in purulent meningitis group( P <0.01).Conclusions:The contents of CSF LA in purulent meningitis and tuberculous meningitis groups were significantly higher than that in normal control group,viral meningitis group and cysticercosis group.[