成人颅内感染性疾病脑脊液检测指标变化的研究

Study on the changes of cerebrospinal fluid detection index in adult intracranial infectious diseases

目的观察成人颅内感染性疾病患者脑脊液中白介素-6(interleukin-6,IL-6)、超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、降钙素原(procalcitonin,PCT)、乳酸脱氢酶(lactic dehydrogenase,LDH)、腺苷脱氨酶(adenosine deaminase,ADA)、胆碱酯酶(cholinesterase,CHE)、谷草转氨酶(glutamic oxalacetic transaminase,AST/GOT)水平的变化,并探讨其临床意义。方法选取郑州大学第二附属医院2015-01—2018-06收治的120例患者,A组为30例化脓性脑膜炎患者,B组为28例病毒性脑膜炎患者,C组为22例结核性脑膜炎患者,D组为40例无颅内感染的患者。检测脑脊液IL-6、hs-CRP、PCT、LDH、ADA、CHE、AST水平,比较4组检测指标。结果 A、B、C组分别与D组相比,A组脑脊液hs-CRP、PCT、ADA水平明显高于D组,差异有统计学意义(P<0. 05); B组脑脊液hs-CRP、PCT、ADA水平与D组相比,差异无统计学意义(P> 0. 05); C组脑脊液ADA水平明显高于D组,差异有统计学意义(P<0. 05); PCT、hs-CRP水平与D组相比,差异无统计学意义(P> 0. 05); A、B、C组IL-6、LDH、CHE、AST水平均明显高于D组,差异有统计学意义(P<0. 05)。结论成人化脓性脑膜炎患者脑脊液中IL-6、hs-CRP、PCT、LDH、ADA、CHE、AST水平明显升高,对化脓性脑膜炎患者具有较高的早期诊断价值; ADA可作为结核性脑膜炎的鉴别诊断指标。

Objective To observe and explore the changes of interleukin 6(IL-6),high sensitive C-reactive protein(hs CRP),procalcitonin(PCT),lactate dehydrogenase(LDH),adenosine deaminase(ADA),cholinesterase(CHE),glutamic oxalacetic transaminase(AST/GOT)in cerebrospinal fluid of adult intracranial infectious diseases.Methods A total of 120 patients admitted to the Second Affiliated Hospital of Zhengzhou University from January 2015 to June 2018 were enrolled.Group A was 30 patients with suppurative meningitis,group B was 28 patients with viral meningitis,group C was 22 patients with tuberculous meningitis,and group D was 40 patients without intracranial infection.All patients were examined for PCT,hs CRP,ADA,IL 6,LDH,CHE,and AST levels,and the differences between the four groups were compared.Results The levels of PCT,hs CRP and ADA in the cerebrospinal fluid of group A were significantly higher than those of group D,and the difference was significant(P<0.05).There was no significant difference in PCT,hs-CRP and ADA levels between the group B and group D(P>0.05).The cerebrospinal fluid ADA level in the group C was significantly higher than that in the group D,the difference was significant(P<0.05);the PCT and hs CRP levels were no significant difference between the group C and group D(P>0.05).The levels of IL 6,LDH,CHE and AST in the A,B and C groups were significantly higher than those in the group D,and the difference was significant(P<0.05).Conclusion The levels of PCT,hs-CRP,ADA,IL-6,LDH,CHE,and AST in cerebrospinal fluid of patients with adult suppurative meningitis are significantly increased,and have high early diagnostic value for patients with purulent meningitis;ADA can be used as a differential diagnosis of tuberculosis meningitis.