【摘要】：目的探討腦脊液(CSF)與血漿生化指標比值對結核性腦膜炎與化膿性腦膜炎的鑒別意義。方法選取2007年1月—2013年12月湖州市中心醫(yī)院神經內科及感染科收治的結核性腦膜炎患者55例(結核性腦膜炎組),化膿性腦膜炎患者73例(化膿性腦膜炎組)。采集患者靜脈血及CSF標本,測定其CSF及血漿糖、蛋白、腺苷脫氨酶(ADA)和氯化物含量,并計算CSF/血漿中上述生化指標的比值。結果兩組CSF糖、蛋白含量比較,差異無統計學意義(P0.05);結核性腦膜炎組氯化物含量低于化膿性腦膜炎組,ADA含量高于化膿性腦膜炎組(P0.05)。兩組血漿糖含量比較,差異無統計學意義(P0.05);結核性腦膜炎組蛋白、氯化物含量低于化膿性腦膜炎組,ADA含量高于化膿性腦膜炎組(P0.05)。兩組CSF/血漿糖比值比較,差異無統計學意義(P0.05);結核性腦膜炎組蛋白比值、ADA比值高于化膿性腦膜炎組,氯化物比值低于化膿性腦膜炎組(P0.05)。繪制CSF/血漿ADA比值聯合氯化物比值診斷結核性腦膜炎的ROC曲線,選取切點ADA比值≥1.19且氯化物比值≤0.93時,靈敏度為78.2%,特異度為78.1%,曲線下面積為0.836。結論 CSF中ADA、氯化物含量和CSF/血漿蛋白、ADA、氯化物比值在結核性腦膜炎中有特定意義,特別是CSF/血漿ADA比值≥1.19聯合氯化物比值≤0.93時對結核性腦膜炎的診斷意義較大,有助于臨床醫(yī)生鑒別結核性腦膜炎和化膿性腦膜炎。
[Abstract]:Objective to study the value of (CSF) / plasma biochemical index ratio in differentiating tuberculous meningitis from suppurative meningitis. Methods from January 2007 to December 2013, 55 patients with tuberculous meningitis (tuberculous meningitis group) and 73 patients with suppurative meningitis (suppurative meningitis group) were selected from Department of Neurology and infection Department of Huzhou Central Hospital. The contents of CSF, plasma glucose, protein, adenosine deaminase (ADA) and chloride were measured in patients with CSF and venous blood samples, and the ratio of these biochemical indexes in plasma of CSF/ was calculated. Results there was no significant difference in the content of CSF sugar and protein between the two groups (P0.05), while the content of chloride in tuberculous meningitis group was lower than that in suppurative meningitis group, and the content of ADA in tuberculous meningitis group was higher than that in suppurative meningitis group (P0.05). There was no significant difference in plasma sugar content between the two groups (P0.05); the content of protein and chloride in tuberculous meningitis group was lower than that in suppurative meningitis group, and the content of ADA was higher than that in suppurative meningitis group (P0.05). There was no significant difference in plasma glucose ratio between the two groups (P0.05); the ratio of protein and ADA in tuberculous meningitis group was higher than that in suppurative meningitis group, and the chloride ratio was lower than that in suppurative meningitis group (P0.05). The ROC curve of CSF/ plasma ADA ratio combined with chloride ratio in the diagnosis of tuberculous meningitis was drawn. When the ADA ratio of the cut point 鈮，

本文編號：2391953