血清心肌酶与CSF中LDH、TNF-α检测对成人颅内感染急性期的临床意义

Clinical significance of detection of serum myocardial enzymes and LDH,TNF-αof CSF in acute phase of adult intracranial infection

目的探讨检测血清乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)及脑脊液(CSF)中LDH、肿瘤坏因子-α(TNF-α)在成人颅内感染急性期中的价值。方法选取2014年1月至2015年12月该院收治的77例确诊颅内感染患者作为观察组,60例神经系统非感染性疾病患者作为对照组,对比两组患者起病7d内的血清LDH、AST、CK及CSF中LDH、TNF-α水平,并进行亚组分析。结果观察组患者血清中LDH、AST、CK及CSF中LDH、TNF-α水平均明显高于对照组患者,差异有统计学意义(P<0.05);化脓性脑膜炎、结核性脑膜炎组患者CSF中LDH水平明显高于病毒性脑炎组(P<0.05);化脓性脑膜炎组患者的CSF中TNF-α水平明显高于结核性脑膜炎和病毒性脑膜炎组(P<0.05)。结论通过检测血清LDH、AST、CK及CSF中LDH、TNF-α水平有利于辅助诊断颅内感染,同时对于颅内感染的病因具有一定的鉴别价值。

Objective To investigate the value of detection of serum LDH,AST,CK and LDH and TNF-αof CSF in the acute phase of adult intracranial infection.Methods Seventy-seven patients with acute stage of intracranial infection in our hospital from January 2014 to December 2015 were selected as the observation group,and 60 patients with non-infectious nervous system diseases were selected as the control group.The levels of serum LDH,AST and CK,and LDH and TNF-αlevels of CSF within 7d after onset were compared between the two groups and the subgroup analysis was performed.Results The levels of serum LDH,AST and CK,and TNF-αand LDH of CSF in the infection group were significantly higher than those in the control group,the difference was statistically significant（P〈0.05）;LDH level of CSF in the purulent meningitis and tuberculous meningitis groups was significantly higher than that in the viral encephalitis group（P〈0.05）;the level of TNF-αof CSF in the purulent meningitis was significantly higher than that in the tuberculous meningitis and viral meningitis groups（P〈0.05）.Conclusion Detecting serum LDH,AST and CK,and LDH and TNF-αlevels of CSF is conducive to the auxiliary diagnosis of intracranial infection,meanwhile has a certain discriminating value for the causes of intracranial infection.