脑脊液乳酸脱氢酶测定在中枢神经系统疾病中的意义

The significance of cerebrospinal fluid lactate dehydrogenase measurement in patients with central nervous system diseases

目的评价脑脊液乳酸脱氢酶(LDH)在中枢神经系统疾病早期诊断和鉴别诊断中应用价值。方法用速率法检测对照组和疾病组(其中包括急性白血病患者,淋巴瘤患者,脑肿瘤患者,脑膜炎患者)脑脊液中的LDH。结果急性白血病患者中的中枢神经系统白血病(CNSL)组脑脊液中LDH水平为(28.68±9.29)U/L,高于无CNSL组,两者比较差异具有统计学意义(P<0.05);淋巴瘤患者中脑转移组脑脊液LDH水平为(125.20±115.24)U/L,高于无脑转移组,两者比较差异具有统计学意义(P<0.05);脑肿瘤患者中脑膜癌病组脑脊液中LDH水平为(77.37±128.15)U/L,高于原发性脑肿瘤组,两者比较差异具有统计学意义(P<0.05);脑膜炎患者中化脓性脑膜炎组脑脊液中LDH水平为(54.48±84.60)U/L,高于病毒性脑膜炎组,两者比较差异具有统计学意义(P<0.05)。结核性脑膜炎组患者脑脊液中LDH水平为(43.54±32.05)U/L,高于病毒性脑膜炎组,两者比较差异具有统计学意义(P<0.05)。结论脑脊液中LDH检测对CNSL、淋巴瘤脑转移及脑膜癌的早期诊断、脑膜炎的鉴别诊断具有重要临床意义。

Objective To evaluate the levels of LDH in cerebrospinal fluid in patients with different types of central nervous sys‐tem diseases .Methods Cerebrospinal fluid LDH were detected by rate assay in control group and disease group（including patients with acute leukemia ,lymphoma ,brain neoplasms and meningitis） .Results In ptients with acute leukemia ,the cerebrospinal fluid LDH level of central nervous system leukemia（CNSL） group was （28 .68 ± 9 .29）U/L ,which was higher than that of non CNSL group ,and the difference were significance（P〈0 .05） .In lymphoma patients ,cerebrospinal fluid LDH level of brain metastasis pa‐tients was （125 .20 ± 115 .24）U/L ,which was higher than that of lymphoma patients without brain metastasis ,the difference was significant（P〈0 .05） .In patients with brain neoplasms ,cerebrospinal fluid LDH level of meningeal carcinomatosis group was （77 . 37 ± 128 .15）U/L ,which was higher than that of primary brain neoplasms group ,the difference was significant（P〈0 .05） .In pa‐tients with meningitis ,cerebrospinal fluid LDH level of tuberculous meningitis group and purulent meningitis group patients were （54 .48 ± 84 .60U/L） and （43 .54 ± 32 .05）U/L respectively ,which were higher than those of viral meningitis group patients ,and the differences were significant （P〈0 .05） .Conclusion LDH in cerebrospinal fluid can be used in early diagnosis of CNSL ,brain metastsisly of mphoma ,meningeal carcinomatosis and differential diagnosis of meningitis .