结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞数与脑脊液生化指标的相关性分析

目的 探讨结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞的变化及与脑脊液常规生化指标的相关性.方法 利用流式细胞仪检测结核性脑膜炎组(46例)、对照组(18人)外周血CD4+、CD8+T淋巴细胞数值,并与脑膜炎患者的脑脊液常规生化指标进行相关性分析.结果 结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞值与对照组比较明显下降.结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞与脑脊液常规生化指标无相关性.抗结核治疗8周后,结核性脑膜炎好转组的患者外周血CD4+、CD8+T淋巴细胞值与恶化组比较差异无统计学意义.结论 结核性脑膜炎患者的细胞免疫功能低于健康对照组;不能单一通过外周血T淋巴细胞的数值去判断结核性脑膜炎的严重程度以及预测其治疗效果.     

病毒性脑炎临床与脑脊液细胞学分析

本文对 ３８例病毒性脑炎发病早期病人的临床表现、脑脊液及脑电图、头部ＣＴ检查进行深入分析。结果发现脑脊液白细胞数增高占５０％，蛋白质增高者占３１．６％，糖和氨化物平均值在正常范围。脑脊液细胞学异常占９４．７％，脑脊液中主要的白细胞反应依次为小淋巴细胞、转化型淋巴细胞、单核样细胞。其中呈淋巴免疫活性细胞反应占６８． ４％，呈淋巴、单核细胞反应占１０．５％，分别是混合细胞反应、单核样细胞反应和嗜中性粒细胞反应者各占 ５． ３％。甚少见浆细胞和嗜酸性粒细胞。头部 ＣＴ检查有异常发现的仅占 ２１．１％，表现为大脑半球皮层、皮层下白质及脑干等多部位的软化灶。脑电图检查异常者占６０． ５％，多为弥漫性慢波和周期性的棘波和慢波。可见，脑脊液细胞学检查具有敏感、直现、稳定等优点，对病毒性脑炎的诊断有重要参考价值。     

小鼠脾和胸腺中贴壁细胞对淋巴细胞分泌CSF的促进作用

淋巴细胞是分泌造血细胞集落刺激因子(Colony—stimulating factor,CSF)的重要细胞群之一。实验结果发现,小鼠脾和胸腺中的贴壁细胞对其淋巴细胞分泌CSF有明显的促进作用。当部分去除脾和胸腺中的贴壁细胞时,淋巴细胞分泌CSF的活性水平明显下降;脾脏淋巴细胞分泌CSF的动态观察显示,淋巴细胞与贴壁细胞同时存在组,分泌CSF的活性水平随培养时间的延长而增高,而部分去除贴壁细胞组,CSF的活性水平很快下降。说明脾和胸腺中的贴壁细胞对于支持脾和胸腺中淋巴细胞分泌CSF有重要的作用。     

人脑豚囊虫病的CSF-细胞学、CSF-ELISA及头颅CT扫描

应用脑脊液细胞玻片离心沉淀法,对35例脑囊虫病人脑脊液(CSF)中白细胞总数、嗜酸性粒细胞、嗜硷性粒细胞、激活淋巴细胞、浆细胞进行分类分析,并与其中23例的CSF猪囊虫ELISA及头颅CT扫描比较。结果提示,CSF细胞学异常(主要表现为嗜酸性粒细胞、浆细胞和嗜硷性粒细胞的增高),特别在ELISA阳性和CT扫描正常者中对本病具有较高的辅助诊断价值。三者配合检测,能提高对本病的诊断率。     

多发性硬化的脑脊液细胞学分析

本文对68例多发性硬化（MS）活动期的病人进行脑脊液检查，结果发现患者脑脊液白细胞增高占29．4％，尤以首次发病者明显。其脑脊液细胞学（CSFC）的改变主要以转化型淋巴细胞反应为主。此外，MS三个临床类型（首次发病、缓解复发型及慢性进展型）的脑脊液细胞反应之间的差异无显著性意义。但缓解复发型和慢性进展型的浆细胞阳性率较首次发病者高（P＜0．05）。因此，观察MS病人CSFC免疫活性细胞反应的变化，对该病的诊断及病期、疗效的判断均有重要意义。     

急性病毒性脑炎和脑膜炎的脑脊液细胞学检查

应用玻片离主法对９８例急性病毒性脑炎和脑膜炎患者进行脑脊液细胞学检查，发病第一周脑脊液中常见激活淋巴细胞和浆细胞，亦可见多种淋巴异常形态如有丝分裂、双核细胞、 核分叶、偶见Ｒｕｓｓｅｌｌ小体及桑椹体，上述改变主要存在于急性病毒性脑炎；它可用以鉴别结核性脑膜炎及多发性硬化。     

急性病毒性脑炎和脑膜炎的脑脊液细胞学检查

应用玻片离心法对９８例急性病毒性脑炎和脑膜炎患者进行脑脊液细胞学检查。发病第一周脑脊液中常见激活淋巴细胞和浆细胞，亦可见多种淋巴细胞异常形态如有丝分裂、双核细胞、异常的核分叶，偶见Ｒｕｓｓｅｌ小体及桑椹体。上述改变主要存在于急性病毒性脑炎；它可用以鉴别结核性脑膜炎及多发性硬化     

25例正常脑脊液的细胞学分析

应用微型沉淀室法对25份腰穿正常脑脊液标本,进行了细胞学检查。发现淋巴细胞为68.8%,单核样细胞为30.70%,嗜中性粒细胞0.35%,嗜酸性粒细胞为0.10%。讨论了各作者所报道的正常脑脊液细液学检查结果不同的原因和嗜酸性或嗜中性粒细胞出现在正常脑脊液中的意义。     

IMPLICATIONS OF LYMPHOCYTE E ROSETTE FORMATION IN CEREBROSPINAL FLUID AND PERIPHERAL BLOOD

Lymphocyte E rosette formation in cere- brospinal fluid (CSF) and blood samples from 23 patients with different neurologic disorders js investigated. 6 individuals, not diagnosed as having immunopathologic disease with normal CSF, were selected as controls. The percentage of rosette forming cells (RFC) was within the range of 58-78% (mean 66.3+7.6%) which is very similar to the blood values. A very significant correlation between CSF and blood values was observed (p<0.01). However, no evident cor- relation between CSF and blood values (p > 0.05) was found in 16 samples from the remaining 15 patients with autoimmune diseases of the nervous system and neurologic disorders pos- sibly causing immunologic abnormalities. Among 9 patients with autoimmune diseases of the nervous system, 1 case of optic neuritis showed increased RFC values with very high CSF values (86% and then 93%) and no amelio- ration was observed. The RFC values in 5 idiopathic polyradiculoneuritis patients seemed to change with the severity and course of the disease, i.e. patients in the acute stage or who were seriously ill had increased percentages in CSF and/or blood and recovered patients or those with mild illness had values within normal range. Two patients with systemic myasthenia gravis had very low CSF RFC values of 3c70 and 39'70 but l with only ocular symptoms had an increased CSF RFC value of 86%. Among 8 patients with neurologic disorders possibly causing immunologic abnormalities, 1 with viral encephalitis had the highest CSF value of 95'/o and l with glioma of the temporal lobe had an increased CSF value of 85tlo but a 10wered blood value of 32.5%. The authors suggest that not only the abn.ormal RFC values but also the abnorma.l differences between CSF and blood values may be of significance. The evident differences between CSF and blood values in pathologic conditions may be caused by the sequestration of blood-brain barrier. Abnormal rosette forma- tion is considered to be due to changes in cyclic nucleotides (cAMP and cGMP) levels in dif- ferent diseases.     

阿尔茨海默病与血管性痴呆患者脑脊液细胞学分析

目的探究脑脊液细胞学检查对于阿尔茨海默病（alzheimer disease,AD）与血管性痴呆（vascular dementia，VD）患者的诊断意义。方法。脑脊液细胞学检查。结果AD组脑脊液细胞学中淋巴细胞较对照组无明显差异，而VD组中脑脊液淋巴细胞较对照组有明显增高。结论观察AD与VD患者脑脊液的细胞学变化，有助于VD的诊断。     

结核性脑膜炎脑脊液细胞学动态观察的临床意义

目的探讨结核性脑膜炎(tuberculous meningitis,TBM)患者脑脊液(cerebrospinal fluid,CSF)细胞学动态观察的临床意义。方法选取我院TBM患者20例,对其应用CSF细胞学检测方法,分析不同时期的TBM的临床特点以及持续时间。结果 TBM患者在临床经抗结核治疗前后CSF的中性粒细胞、激活单核细胞、小淋巴细胞、单核细胞、转移淋巴细胞以及淋巴样细胞所占比例具有统计学意义(χ2=2.055、1.583、2.054、3.512、2.025、2.050,P<0.05)。细胞学诊断结果治疗前后比较具有统计学意义(χ2=2.157、3.145,P<0.05)。结论 CSF细胞学动态检测对判断患者的治疗情况具有一定的指导意义。     

Wistar大鼠树突状细胞的体外培养、扩增与鉴定

目的：探讨体外分离、培养和扩增大鼠骨髓来源树突状细胞（DC）的有效方法。方法：采用改良的Chen－WoanDC培养方法，梯度离心提取骨髓单核细胞中的非粘附细胞，加入GM CSF 5?ng/ml、IL 4 5?ng/ml进行诱导扩增，对培养的目的细胞进行形态学、OX62－FITC免疫荧光检查以及功能学鉴定。结果：DC前体细胞培养10?d呈典型树突状结构，表面标志物染色阳性，流式细胞学检查OX62单抗阳性率86％，不同培养时段的DC诱发混合淋巴细胞反应以培养10?d的DC最强，培养10?d的DC诱发混合淋巴细胞反应对同源淋巴细胞有更好的活性。结论：改良的Chen－Woan法为体外诱导扩增大鼠骨髓来源DC的有效方法。     

莱姆病的神经系统表现

报告８例莱姆病的神经系统表现，累及中枢神经和周转神经系统，脑膜炎２例，脊髓病２例，周围神经病５例，面神经麻痹２例。脑脊液检查；压力，蛋白，白细胞数增高２例。细胞学检查淋巴细胞为主，有激活淋巴细胞，嗜酸性粒细胞。     

脑血吸虫病影像学与免疫学诊断研究

目的探讨脑血吸虫病的影像学与免疫学诊断特点及价值。方法分析22例疑似脑型血吸虫病病人的CT、MRI及血液和脑脊液免疫学检查资料。结果经CT、MRI诊断的病人中18人为脑血吸虫病,血清酶联免疫吸附试验(ELISA)中有2人为假阴性,脑脊液酶联免疫吸附试验(ELISA)检查中5人假阴性。结论CT、MRI及血液和脑脊液免疫学检查对脑型血吸虫病的诊断有很大的价值,MRI和脑脊液免疫学检查尤为重要。     

Alzheimer病脑脊液磷酸化神经丝及以螺旋丝兔免疫活性

目的 建立测定脑脊液（CSF）中磷酸化神经丝（PNF）和双螺旋丝（PHF）免疫活性的检测方法,并探讨Alzheimer病（AD）患者CSF中PNF和PHF免疫活性的变化及其临床意义。方法 采用单克隆抗体作探针,建立竞争抑制型酶联免疫吸附试验（ELISA）检测AD的CSF中PNF和PHF的免疫活性,并与对照组即多发梗塞性痴呆（MID）、其他神经疾病（ODC）、精神分裂症（SCH）和正常人（NC）进行比较。结果 AD组CSF中PNF免疫活性与MID、NC SCH组无显著性差异（P＞0．05）。AD组CSF中PHF活性高于各对照组（P＜0．05）,而其PNF／PHF比值低于各对照组（P＜0．001）,有显著性意义。结论 单纯测定CSF中PNF免疫活性时AD的诊断和鉴别无意义;测定CSF中PHF免疫活性对AD的诊断和鉴别有一定的价值;PNF／PHF比值对AD的诊断和鉴别亦有相当价值;将测定CSF中的PHF活性与PNF／PHF比值相结合可提高AD的诊断正确率,有可能发展为有临床意义的实验室诊断试验。     

婴儿颅内出血与髓鞘碱性蛋白的关系

目的：检测颅内出血患儿脑脊液和血清髓鞘碱性蛋白（ＭＢＰ）的含量，探讨本病脑损害和ＭＢＰ含量变化的关系。方法：采用简易ＭＢＰ ＥＬＩＳＡ法对３８例脑实质（或伴腔室）出血及腔室内（硬膜下腔、蛛网膜下腔、脑室）出血患儿脑脊液和血清标本作ＭＢＰ定量测定，与对照组比较，并于治疗４￣５周后复查对比。结果：两出血组脑脊液和血清ＭＢＰ的含量明显高行对照组（Ｐ均〈０．０１），有脑实质出血组脑脊液和血清ＭＢＰ含量同于     

Cerebrospinal fluid/serum lactic acid in febrile convulsions

Cerebrospinal fluid/serum lactic acid was prospectively assayed in 42 patients with febrile convulsions. Patients were divided into two groups for analytical purposes. Those with brief febrile seizures (30 patients) and the remaining 12 patients had prolonged febrile seizures. CSF and serum lactic acid values were within normal range in patients with brief seizures while elevated values were obtained in patients with prolonged seizures. The mean CSF lactic acid on admission was significantly higher (P less than 0.001) in patients with prolonged seizures than corresponding values in those with brief seizures. Mean serum lactic acid on admission was also significantly higher in patients with prolonged febrile seizures compared to the corresponding mean value in patients with brief seizures (P greater than 0.001). Patients who recovered with neurological deficits had significantly higher CSF lactic acid on admission (P greater than 0.001). Similarly 8 patients who had recurrent febrile convulsions had significantly higher CSF lactate on admission. It is suggested that measurement of CSF lactate can be used as a biochemical marker to identify children with prolonged seizures and those who are likely to have recurrent febrile seizures.     

Identification of Hemorrhagic Fever with Renal Syndrome(HFRS)Virus in Central Nervous System of Patients with HFRS

The location of hemorrhagic fever with renal syndrome(HFRS)virus in thecentral nervous system(CNS)of patients with HFRS was studied by reverse passive he-magglutination(RPHA),RPHA inhibition test(RPHI),immunohistochcmistry,and cellculture assays.HFRS virus antigen was picked out in the soluble supernatant of cerebro-spinal fluid(CSF)by RPHA;and HFRS viruses were identified in the cytoplasm of mo-nocytes and lymphocytes in CSF by FA or PAP staining;HFRS viruses were isolatedfrom CSF of patients;and furthermore,HFRS virus antigen was detected in ncuroglio-cytes of brain by IFA,FA,PAP and ABC staining.All the results indicate that HFRSvirus could infect the CNS of the patients via Mood-brain barrier.     

小儿神经系统疾病脑脊液酸碱气体变化及临床意义

本文报道了９０例小儿神经疾病脑脊液和动脉血酸碱气体分析结果。发瑞神经地，脑脊省府 酸碱气体变化是非常重要而敏感的指标，它有助于鉴别细菌性和非细菌怀服炎，并可帮助判断神经疾病的预后，指导治疗的作用。     

脑脊液中皮质醇正常水平及其临床意义的初步探讨

本文报告35例正常人脑脊液皮质醇(CF)含量及其与血浆皮质醇(BF)含量之比值。发现CF约为BF的10％,且有昼夜节律变化。16例急性脑血管病患者CF/BF值高于正常组,昼夜节律消失;6例脑瘤患者中,4例CF/BF值和正常组相似,2例显著升高,表明某些中枢神经系统疾病可增加血——脑脊液对皮质醇的通透性。