精神障碍型与非精神障碍型散发性脑炎脑脊液和临床的对照研究

摘要

To study the characteristics of changes of CSF andeff ects ofanti-virus treatment in sporadic encephalitis patientswith and without mental disorders.Methods lumbar CSF presure was measured and amount of CSF was adopted for examin ation. Analysis of variance and T test were used to define the differences in ch anges of CSF and effects ofanti-virus treatment in sporadic encephalitis patient s with and without mental disorders.Results All patints showed mild to moderate ,partly notentir ely CSF abnormity,Pa tients with mental disorders had higher rate and severer degree in CSF abnormity .whatever accounted in one or more aspects of CSF contents,as compared with that of patients without mental disorders,there were significant differences in Pand y test and CSF protein between these two group patients,Effects of anti-virus tr eatments including usage of adenosiue arabinoside were better on patients with m ental disorders than on patients without mental disorders. Conclusions We found that marked CSF abnormity was often see n in patients with mental disorders,which may be due to the marked cortical inju ry and meningeal reaction caused by virus derectly attacks ,and this type of spo radic encephalitis may be effective to adenosine arabinoside and other anti-viru s treatment.%目的：通过对照分析两组脑脊液的表现，探讨精神障碍型散发性脑炎和非精神障碍型散发性脑炎脑脊液改变的特点与治疗转归的关系。方法：两组散发性脑炎都通过腰穿测定脑脊液压力并取适量脑脊液做常规和生化检查，结果用方差分析和T检验比较两组脑脊液的差异，初步比较两组散发性脑炎抗病毒治疗的临床效果。结果，两组脑脊液都只表现部分常规内容的项目异常而无全部内容异常的病例，脑脊液异常也都以轻、中度为主。通过比较分析，精神障碍型散发性脑炎脑脊液改变不论是单项内容异常或多项内容异常，其发生率和异常程度都高于非精神障碍型散发性脑炎，尤其是潘迪氏和蛋白定量二项异常两组比较有极显著性差别；而且，精神障碍型发性脑炎用阿糖胞苷等抗病毒治疗效果表现出优于非精神障碍型散发性脑炎。结论：精神障碍突出的散发性脑炎其脑脊液改变常较明显，认为这类散发性脑炎可能与病毒直接感染造成的、以脑表面灰质损害为主和脑膜反应相对明显的特点相关，是阿糖胞苷等抗病毒治疗的合理选择。