流行性乙型脑炎患者脑脊液细胞学及生化特点

The characteristics of the cerebrospinal fluid cytology and biochemical test in patients with epidemic encephalitis B

目的 分析流行性乙型脑炎(以下简称“乙脑”)患者脑脊液(CSF)细胞学及生化特点。方法回顾性收集2018-07-2018-9期间宁夏医科大学总医院收治的乙脑患者58例,其中男31例、女27例,平均年龄(58.2±13.8)岁,分析患者CSF细胞学及生化检查的临床资料。结果所有患者CSF细胞学检查可见炎性反应,炎性反应程度以中度为主(50.0%),其次为重度(36.2%)和轻度(13.8%)。细胞学反应类型主要以淋巴细胞反应为主(53.4%),其次以中性粒细胞反应为主(27.6%)、淋巴细胞和中性粒细胞混合反应为主(15.5%)、淋巴细胞和单核细胞反应为主(3.4%)。9例(15.5%)患者CSF可见激活的淋巴细胞,11例(19.0%)可见激活的单核细胞,22例(37.9%)可见浆细胞。53例(91.4%)患者CSF蛋白升高,45例(77.6%)CSF葡萄糖水平正常,35例(60.3%)CSF氯化物水平正常。乙脑患者初期CSF细胞学反应类型以淋巴细胞反应为主(38.7%)和以中性粒细胞反应为主(38.7%),极期和恢复期主要以淋巴细胞反应为主(74.3%、95.2%)。结论CSF细胞学检查可为乙脑患者的诊断提供实验室参考依据。

Objective To analyze the characteristics of cerebrospinal fluid(CSF)cytology and biochemical test in the patients with epidemic encephalitis B.Methods The CSF cytology and biochemical data of the 58 patients with epidemic encephalitis B admitted to the General Hospital of Ningxia Medical University from July 2018 to September 2018 were retrospectively collected and analyzed.There were 31 males and 27 females,averaging(58.2±13.8)years.Results Visible inflammation presented in all the patients CSF.There were mild inflammatory reaction in 13.8%,moderate inflammation in 50.0%,and severe inflammation in 36.2%of the patients.Among the patients,53.4%were classified to lymphocytic inflammation,27.6%neutrophilic inflammation,15.5%lymphocytic and neutrophilic inflammation,and 3.4%lymphocytic and monocytic inflammation.Additionally,activated lymphocytes were seen in 9(15.5%),activated monocytes in 11(19.0%),and plasmocyte in 22(37.9%)cases.Elevated CSF protein presented in 53(91.4%)patients.The levels of glucose and chloride were normal in 45(77.6%)and 35(60.3%)patients respectively.In the early stage,the lymphocytic and neutrophilic inflammation reactions were observed(38.7%,38.7%).Lymphocytic inflammation responses were predominant in the climax phase and the convalescence phase(74.3%,95.2%).Conclusions The cerebrospinal fluid cytology test may provide laboratory support for clinical diagnosis.