病毒性脑膜炎和结核性脑膜炎脑脊液细胞学动态观察对比分析

Comparison of the cytological features of cerebrospinal fluid between viral menigitis and tuberculous meningitis

目的对比分析病毒性脑膜炎（viral menigitis,VM）和结核性脑膜炎（tuberculous meningitis,TBM）脑脊液细胞学变化特点。方法用Cytospin-4型玻片离心沉淀仪收集细胞法,对30例VM和30例TBM患者的脑脊液细胞学分类情况进行动态观察和分析。结果多数VM患者脑脊液白细胞中嗜中性粒细胞在1-3 d内迅速减少或消失,随后呈淋巴细胞学反应,随病情好转细胞数恢复正常;TBM患者脑脊液白细胞早期以嗜中性粒细胞为主,随后呈混合细胞学反应,嗜中性粒细胞多在1个月后才有明显降低,随病情好转变为以淋巴细胞为主直至正常化。结论 VM和TBM的脑脊液细胞学动态变化过程有明显差别,脑脊液细胞学技术对2种病的鉴别诊断有重要价值。

Objective To investigate the cytological features of the cerebrospinal fluid （CSF） in the clinical diagnosis of the viral menigitis （VM） and the tuberculous meningitis （TBM）. Methods By using the cerebrospinal fluid sedmient chamber method, the cytological features of cerebrospinal fluid of 60 cases （30 cases of VM and 30 cases of TBM） were dynamically observed and analysed. Results The neutrophils in CSF of most VM patients decreased rapidly or disappeared in 1 to 3 days followed by lymphoid cell reaction. However, in CSF of TBM patients, the neutrophils increased obviously in the initial stage followed by mixed cell reaction, and then neutrophilic granulocytes disappeared gradually after 1 month with the occurrence of lymphocytes. Conclusion The cytological features of CSF between VM and TBM are obviously different, and they play an important role in the differential diagnosis of VM and TBM.