病毒IgM抗体及细胞学检测对病毒性脑炎的诊断价值

目的探讨病毒性脑炎的脑脊液和血清病毒IgM抗体检测对病毒性脑炎的诊断特异性和应用价值。方法78例于2007年4月～2008年6月就诊于我院,诊断为病毒性脑炎(46例)、脑膜炎(32例)的患者,于入院10d内对血和脑脊液病毒IgM抗体检测。结果78例患者血清中共检测出病毒抗体阳性48例,阳性率61.5%。以COXB和EBV为主要病原。78例患者中有52例进行了脑脊液抗体检测,阳性9例,阳性率17.3%。以HSV和EBV为主要病原。78例患者中有39例行镜下细胞学分类,淋巴细胞为主32例、单核细胞为主1例、中性粒细胞为主6例。结论用ELISA法检测病毒特异性IgM抗体是早期确定病毒性脑炎病原的较理想方法,CSF细胞学检查快速、简便,是诊断CNS病毒感染的重要指标之一。

The diagnostic value of detecting IgM and cytology of viral encephalitis

Objective To investigate diagnostic value of detecting IgM in both blood and fluid of viral encephalitis.Methods 78 patients who were diagnosed as viral encephalitis or meningitis from April 2007 to June 2008 received viral IgM detecting in both blood and cerebral fluid.Results There are 48 patients of the total 78 cases with positive results in blood viral IgM detecting,with the ratio of 62.7%,while the COXB and EBV are most prevalent.There are 9 patients of the total 52 cases with positive results in cerebral fluid viral IgM detecting,with the ratio of 17.3%,while the HSV and EBV are most prevalent.39 of the total 78 cases are given cytology analysis,and 32 cases mainly consist of lymphocyte,1 case mainly consists of monocyte,while 6 cases mainly consist of granulocyte.Conclusion Detecting specific IgM by the method of ELISA is a relatively ideal method to diagnose viral encephalitis early,and the cytology analysis of cerebral fluid is fast,convenient and important to diagnose viral infection in central nervous system.