不同病原体中枢神经系统感染患者血清和脑脊液中一氧化氮 总一氧化氮合酶的动态变化

目的观察不同病原体所致中枢神经系统（CNS）感染患者脑脊液（CSF）及血清中一氧化氮（NO）浓度、总一氧化氮合酶（NOS）活力的动态变化，为临床鉴别不同病原体所致中枢神经系统感染提供实验室依据。方法硝酸还原酶法和化学比色法检测30例中枢神经系统感染患者治疗前、治疗2周后CSF中及入院时、住院第3、5、9、14天血清中NO浓度、总NOS活力的动态变化。结果中枢神经系统感染患者不同病原体所致病毒性脑膜炎、化脓性脑膜炎、结核性脑膜炎组不同时点血清NO浓度、总NOS活力组间比较，差异均无统计学意义（P〉0.05）；病毒性脑膜炎、化脓性脑膜炎、结核性脑膜炎患者治疗前、治疗2周后脑脊液中NO浓度、总NOS活力之间差异均无统计学意义（P〉0．05）。结论血清中NO浓度、总NOS活力尚不能作为化脓性脑膜炎、病毒性脑膜炎、结核性脑膜炎临床鉴别诊断的实验室依据之一。

A study of dynamic changes of NO, NOS in serum and CSF in patients with CNS infection

Objective To observe the dynamic changes of NO, NOS in serum and CSF in patients with CNS infection and lay an experimental basis for discrimination of CNS infection due to different agents. Methods The method of nitrate redutase and the method of chromometry were employed to measure NO, NOS in serum and CSF at different time. The dynamic changes of NO, NOS in serum were observed on admission, on 3,5,9,14 day after admission. The dynamic changes of NO, NOS in CSF before treatment and two weeks after treatment were observed, too. Results There were no difference between the the concentration of NO and the vigor of total NOS in serum and in CSF of viral meningitis, bacterial meningitis and tubercular meningitis patients due to different agents. Conclusion The changes of the concentration of NO in serum and CSF, the vigor of total NOS in serum and CSF could not be seen as laboratory basis for discrimination of CNS infection due to different agents.