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54例急性細菌性和隱球菌性腦膜炎實驗室指標的比較

注意:本論文已在《中華臨床醫藥雜志(北京)》,2002,3(15): 13-15. 2002年3卷15期13-15頁發表
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賀斌 趙忠新 邵福源
第二軍醫大學附屬長征醫院神經內科,上海,200003

摘要:目的 研究多項實驗室檢測指標在急性細菌性和隱球菌性腦膜炎鑒別診斷中的量化標準和意義,并探討其臨床應用價值。方法 對26例急性細菌性和28例隱球菌性腦膜炎病人進行回顧性研究,分別比較其外周血和腦脊液的檢測結果。結果 從周圍血中性粒細胞百分數、腦脊液糖含量上很難鑒別急性細菌性和隱球菌性腦膜炎。與隱球菌腦膜炎相比,當周圍血白細胞總數?2.0?109/L、腦脊液白細胞總數?1000.0?106/L、中性粒細胞數?500.0?106/ L、腦脊液糖?1.7mmol/L、蛋白?2.0g / L、腦脊液糖與血糖比值? 0.35時應高度懷疑細菌性腦膜炎。細菌性腦膜炎腦脊液蛋白增高與血糖水平呈正相關。結論 上述量化標準有助于提高細菌性與隱球菌性腦膜炎鑒別診斷的敏感性和準確性,降低誤診率。
[關鍵詞] 細菌性腦膜炎 隱球菌性腦膜炎 腦脊液 鑒別診斷

Retrospective study of differential diadynamic criteria in 54 patients with acute bacterical and cryptococcal meningitis


He bin,Zhao zhong-xin, Shao fu-yuan. Department of Neurology, Changzheng hospital, Second Military Medical University, Shanghai, 200003.

Abstract: Department of Neurology, Changzheng hospital, Second Military Medical University, Shanghai, 200003
Summary: Objective: To analyze the quantitive standards and sensitivity of multiple laboratory marker in the differential diagnosis of bacterial or cryptococcal meningitis and try to discuss its clinical value. Method: 54 patients with acute bacterial and cryptococcal meningitis were retrospectively analyzed . Peripheral blood picture and laboratory findings of cerebrospianl fluid(CSF) were compared respectively. Result: Acute bacterical meningitis was hardly differentiated from cryptococcal one by peripheral blood polymorphonuclear leukocytes percentage and CSF glucose level. But acute bacterical meningitis should be highly suspected in patients with peripheral WBC count more than 2.0?109/L , more than 1000.0?106/L CSF leukocytes, more than 500.0?106/L CSF polymorphonuclear leukocytes, CSF glucose level less than 1.7mmol/L, a CSF-blood glucose ratio less than 0.35, or a CSF protein level greater than 2.0g/L. The probability of CSF protein elevation in acute bacterial meningitis was positively corrected with blood glucose level. Conclusion: the quantitive standard and main differential points of multiple laboratory marker help to increase the diagnostic accuracy of acute bacterical meningitis from cryptococcal one and decrease the rate of missed diagnosis.
Key word: bacterical meningitis cryptococcal meningitis cerebrospianl fluid diferential diagnosis

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本站收錄的本文作者的其他論文:

1、 腰骶部體感誘發電位對脊髓病變的定位診斷

2、脛后神經脊髓體感誘發電位的起源及其臨床應用

3、57例隱球菌性和結核性腦膜炎腦脊液指標的動態研究

 

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