成人化脓性脑膜炎患者脑脊液变化

The changes of cerebrospinal fluid in adult suppurative meningitis patients

目的分析成人化脓性脑膜炎患者脑脊液细胞、病原菌等的变化及其关系,为该病的有效诊断、病情监测和针对性治疗提供参考。方法对我院32例成人化脓性脑膜炎患者用药前后不同时期的脑脊液分别进行常规、生化与细胞学检测,对检测结果进行统计分析。结果与恢复期比较,患者急性期时脑压、脑脊液白细胞总数与乳酸脱氢酶水平显著升高(均P<0.05)。32例患者中,15例脑脊液细菌培养呈阳性。典型菌与非典型菌感染者急性期脑脊液白细胞总数、小淋巴细胞、单核吞噬细胞和嗜中性粒细胞比例差异均有统计学意义(均P<0.05)。结论成人化脓性脑膜炎患者脑脊液变化显著,脑脊液细胞学变化与感染类型相关,可为个性化诊疗提供参考。

Objective To analyze the changes of cerebrospinal fluid cells and pathogens in adult patients with suppurative meningitis(SM),and lay the groundwork for effective diagnosis,condition monitoring and targeted treatment of SM.Methods The cerebrospinal fluid of 32adult patients with SM were detected using conventional,biochemical and cytological tests before and after treatment.Then the results were statistically analyzed.Results Compared with the recovery stage,the brain pressure,total leukocyte count,protein and lactate dehydrogenase in patients with SM during acute phase increased significantly(all P<0.05).Among the 32patients,15cases were positive for cerebrospinal fluid bacterial culturing.There were significant differences in total leukocyte count,small lymphocytes,mononuclear phagocytes and neutrophils between typical bacterial infection and atypical bacterial infection(all P<0.05).Conclusion The cerebrospinal fluid of adult SM patients changes significantly.The cytological changes of cerebrospinal fluid are related to the infection type.This result can provide a basis for personalized diagnosis and treatment of the disease.