病毒性脑炎124例脑脊液分析

Viral encephalitis:An analysis of cerebrospinal fl uid from 124 cases

目的分析病毒性脑炎的脑脊液(cerebrospinal fluid,CSF)变化特点,为早期临床诊治提供依据。方法回顾性分析解放军总医院2004年1月-2012年12月诊断的124例病毒性脑炎患者的临床资料,CSF常规、生化以及细胞学检查结果。结果 124例中,CSF异常105例(84.6%),包括颅内压升高46例(37.1%);CSF白细胞计数升高94例(75.8%),最高达360×106/L;CSF细胞学检查异常103例(83.1%),主要以淋巴细胞反应(86.4%)或单核细胞反应(9.7%)为主;蛋白质升高70例(56.5%),葡萄糖含量降低6例(4.8%),氯化物全部正常。19例(15.4%)各项结果完全正常。结论 CSF常规、生化及细胞学检查对病毒性脑炎的早期临床诊断具有重要临床意义。

Objective To provide the evidence for early diagnosis and treatment of viral encephalitis by analyzing the features of cerebrospinal fluid （CSF） from viral encephalitis patients. Methods Clinical data and routine, biochemical and cytological findings in CSF from 124 viral encephalitis patients admitted to our hospital from January 2004 to December 2012 were retrospectively analyzed. Results Of 124 patients, 105 （84.6%） were found to have abnormal CSF, including elevated intracranial pressure in 46 （37.1%）, increased white cell counts in 94 （75.8%） with a peak of 360 × 10^6 /L. Of 124 patients, 103 （83.1%） were found to have abnormal CSF cytology characterized by lymphocyte pleocytosis （86.4%） or monocyte pleocytosis （9.7%）, 70 （56.5%） had an increased protein level and 6 （4.8%） had a decreased glucose level. However, their chloride level was normal. The CSF was normal in 19 patients （15.4%）. Conclusion Routine, biochemical and cytological examination of CSF play an important role in early diagnosis of viral encephalitis.