成人颅内感染性疾病脑脊液检测指标变化的研究

摘要

Objective To observe and explore the changes of interleukin-6 (IL-6), high sensitive C-reactive protein (hsCRP), 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.%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.