结核性脑膜炎患者脑脊液 CD64 Cys-C 及 ADA 水平的检测意义

摘要

目的：分析结核性脑膜炎患者脑脊液中性粒细胞表面膜糖蛋白（CD64）、血清胱抑素C（Cys‐C）及腺苷脱氨酶（ADA ）水平的检测意义。方法选取我院193例住院患者为对象，结核性脑膜炎102例，化脓性脑膜炎35例，病毒性脑膜炎30例，非感染性神经系统疾病26例，免疫透射比浊法检测4组Cys‐C、流式细胞术检测CD64、酶标法检测ADA ，比较4组CD64、Cys‐C及ADA水平，并比较单一指标检测与联合检查结核性脑膜炎的诊断符合率。结果结核性脑膜炎患者Cys‐C、ADA、CD64均显著高于非感染性神经系统疾病患者（P＜0.05），结核性脑膜炎组、化脓性脑膜炎组、病毒性脑膜炎组3项指标呈递减趋势，病毒性脑膜炎与非感染性神经系统疾病组CD64、Cys‐C比较差异无统计学意义（P＞0.05），结核性脑膜炎组与化脓性脑膜炎组Cys‐C比较差异无统计学意义（P＞0.05），其他组间比较差异均有统计学意义（P＜0.05）；Cys‐C、ADA、CD64诊断符合率分别为78.43％、60.73％、70.59％，联合诊断符合率98.04％，显著高于单一诊断。结论 CD64、Cys‐C及 ADA均为结核性脑膜炎的有效检测指标，联合检查有助于提高结核性脑膜炎的诊断准确率及与其他类型脑膜炎的鉴别，具有较高的临床应用价值。%Objective To study the detection significance of neutral granulocyte surface film glycoprotein (CD64) ,serum cystatin C (Cys‐C ) and adenosine deaminase (ADA ) levels in cerebrospinal fluid of patients with tuberculous meningi‐tis.Methods 193 cases of patients admitted to our hospital were selected as subjects ,among whom 102 cases of tuberculous meningitis ,35 cases of purulent meningitis and 30 cases of viral meningitis ,and 26 cases of non‐infectious neurological disea‐ses. Cys‐C levels of the four groups were detected by immunoturbidimetry ,CD64 by flow cytometry and ADA by enzyme‐la‐belled immunosorbent assay. The levels of CD64 ,Cys‐C ,ADA and the diagnostic accordance rates of single index detection and combined detection in the diagnosis of tuberculous meningitis were compared among the four groups.Results The levels of Cys‐C ,ADA and CD64 in patients with tuberculous meningitis were significantly higher than those of non‐infectious neurologi‐cal diseases group (P<0.05). The three indicators in tuberculous meningitis group ,purulent meningitis group and viral men‐ingitis group showed a decreasing trend. The comparison of CD64 and Cys‐C between the viral meningitis group and non‐infec‐tious neurological diseases group was not statistically significant (P>0.05). The comparison of Cys‐C between the tuberculous meningitis group and the purulent meningitis group was not statistically significant (P>0.05). And comparisons among the other groups were statistically significant (P<0.05);the diagnosis coincidence rates of Cys‐C ,ADA and CD64 respectively were 78.43% ,60.73% and 70.59% . The diagnosis coincidence rate of combined detection was 98.04% ,which was signifi‐cantly higher than that of single diagnosis.Conclusion CD64 ,Cys‐C and ADA are effective detection indicators for tuberculous meningitis. The combined detection can help to improve the accuracy of diagnosis of tuberculous meningitis and differentiation of other types of meningitis ,which is of higher clinical application value.