中枢神经系统感染105例脑脊液细胞学检查的结果分析

脑脊液细胞学卜sf－C）检查目前已越来越）“泛的应用于临床,。sf－C检查不仅是中枢神经系统感染性疾病的一项极有价值的辅助诊断,而且是评价和判断预后的一项很有意义的实验室技术。本文采用粟化Csf－C检查法对105例中枢神经系统感染患者的脑脊液进行细胞学、常规及生化检查,且的在于研究不同致病原导致的中枢系统感染的脑脊液细胞学变化特点及脑脊液细胞学检查阳性率与常现、生化检查阳性率比较。1研究对象与方法1．1对象本组105例,其中男53例,女52例,年龄3一乃岁,其中化脓性脑炎12例,结脑14例,病毒性脑炎6例,散发性脑炎15例…     

利用脑脊液细胞学和流式细胞学诊断的原发性中枢神经系统淋巴瘤1例报告

原发性中枢神经系统淋巴瘤( primary central nervous sys-tem lymphoma,PCNSL) 是一种罕见的原发于颅内的非霍奇金淋巴瘤,是会危及患者生命的肿瘤,早期诊断和及时的治疗方案,对提高患者生存率具有重要的临床价值.PCNSL的头部影像学检查虽然有一定的特点,但局限性很大,非典型病例难...     

脑脊液细胞学在中枢神经系统白血病诊治中的应用

目的探讨脑脊液细胞学在中枢神经系统白血病(CNSL)的诊断、病情进展及指导治疗中的作用。方法采用粟氏FMU-5型细胞玻片离心沉淀仪收集脑脊液细胞,迈-格-姬(MGG)染色,显微镜下进行细胞分类,计数白血病细胞所占的百分比。分析2000～2008年我院住院的58例CNSL患者的脑脊液细胞学检查结果。结果 58例患者包括19例儿童和39例成人病例。其脑脊液细胞学均发现白血病细胞,占脑脊液细胞的5～96%。其中5例首次检测诊断为CNSL后失访,其余病例均于治疗过程中重复进行脑脊液细胞学检查。白血病细胞所占比例多数呈不同程度的降低,直至完全消失;11例比值出现反复,最终逐渐降低;8例未见明显降低。结论脑脊液细胞学检查对CNSL的诊断、治疗及预后评估具有重要的临床意义。     

“脑脊液”液基细胞学检查在中枢神经系统疾病诊断中的应用价值

目的 探讨"脑脊液"液基细胞学在中枢神经系统疾病中的诊断价值.方法 分析41例"脑脊液"液基细胞学检查结果 .结果 液基细胞学检查"脑脊液",根据细胞独特的形态学特点,作出初步诊断.结论 "脑脊液"液基细胞学检查对临床诊断各种疾病有一定的诊断价值,能弥补"脑脊液"常规检查方法 易漏诊获取细胞少的缺陷[1].     

脑脊液细胞学检查对中枢神经系统疾病的诊疗作用

目的研究脑脊液细胞学检查在中枢神经系统疾病中的诊断与治疗作用。方法选取2008-01—2012-10入院治疗的中枢神经系统疾病患者362例,应用侯氏改良Sayk氏细胞沉淀室进行脑脊液细胞学检查。结果 362例患者中支持原诊断149例(41.16%),具有诊断参考价值114例(31.49%),总有效诊断72.6%。治疗后患者的生活质量提高。结论脑脊液细胞学检查在诊治中枢神经系统疾病中有重要参考价值。     

脑膜癌病68例脑脊液细胞学分析

目的探讨脑脊液检查对诊断脑膜癌病的重要意义。方法对68例确证的脑膜癌病患者临床资料进行回顾性分析。结果本组患者主要临床表现为头痛、恶心呕吐,脑膜刺激征等;仅15例患者的头部MRI增强扫描显示脑膜异常强化;脑脊液压力均增高,细胞数增多45例,常呈中-重度增加,并以激活型单核细胞增加为主,68例患者在脑脊液中均发现肿瘤细胞。结论脑膜癌病的临床表现及影像学缺乏特异性,脑脊液检查尤其是细胞学检查是诊断该病的可靠依据,而进行多次脑脊液细胞学检查可提高诊断准确率。     

8例脑膜癌病临床与脑脊液细胞学分析

脑膜癌病（Meningeal Carcinomatosis，MC）亦称癌性脑膜炎，系中枢神经系统转移瘤的一种少见类型，是恶性肿瘤通过血行转移或脑脊液种植播散而累及脑膜，脑、脊髓内并无明显肿块的一种非独立性的严重疾病，此病确诊主要依赖脑脊液细胞学。本文结合文献资料，对2年来经脑脊液细胞学诊断的8例MC临床资料进行回顾分析。     

神经白塞综合征的临床和脑脊液细胞学特点

目的回顾性分析神经白塞综合征(NBS)临床和脑脊液(CSF)细胞学资料,探讨该病的临床和CSF细胞学特点。方法回顾1991-2010年间北京协和医院NBS住院患者共27例,分析其临床表现、神经影像学和CSF细胞学特点。结果 27例患者中,神经科症状急性病程19例,亚急性病程6例,慢性病程2例。临床表现:头痛9例,偏瘫8例,复视6例,偏身感觉障碍5例,意识障碍5例,失语3例,癫痫发作3例,精神行为异常、智能减退6例,截瘫2例,共济失调2例,呛咳、吞咽困难2例,帕金森综合征1例。头MRI异常16例,多发片状T1低或较低信号,T2高信号,病灶分布于基底节、脑干、丘脑等处,9例行增强MRI均有强化;2例颈段脊髓MRI可见强化病灶。磁共振静脉成像(MRV):1例符合上矢状窦血栓形成。CSF检查:19例行腰穿查CSF,其中8例压力升高,17例蛋白升高(0.48～1.08g/L);行CSF细胞学检查(沉淀池法制片,迈-格-姬染色)的11例中7例表现为淋巴细胞为主的炎性反应,其中6例伴有中性粒细胞比例升高,余4例中3例为淋巴细胞与中性粒细胞为主的混合性炎性反应,1例为中性粒细胞性炎性反应,8例可见激活淋巴细胞,4例可见浆细胞。结论 NBS临床表现多样,神经影像学改变以基底节、脑干和丘脑等邻近中线的结构受累为主,CSF细胞学呈炎性反应表现。CSF细胞学炎性反应类型,特别是CSF中性粒细胞比例升高对NBS的诊断具有一定意义。     

38例神经梅毒脑脊液检查结果分析

神经梅毒是由梅毒螺旋体引起的中枢神经系统感染性疾病,其临床表现复杂,诊断应结合临床表现、实验室及影像学检查综合分析,而脑脊液异常是诊断神经梅毒的必要依据之一.现对我院神经内科于2000-01～2009-12收治的38例神经梅毒患者的脑脊液检查结果分析如下,并探讨其对临床诊断的意义.     

隐球菌性脑膜炎23例脑脊液细胞学分析

目的分析隐球菌性脑膜炎脑脊液细胞学特点,比较脑脊液细胞学染色、墨汁染色、乳胶凝集实验检出隐球菌的敏感度及特异度,以提高对隐球菌性脑膜炎的认识。方法总结2008年1月至2013年2月确诊的23例隐球菌脑膜炎患者与同期住院的23例非隐球菌脑膜炎患者临床资料及脑脊液细胞学资料并予以分析。结果脑脊液细胞瑞氏吉姆萨染色检测灵敏度91.3%,明显高于墨汁染色灵敏度43.4%,差异有统计学意义(P0.05);脑脊液细胞学瑞氏吉姆萨染色检测特异度100%,明显高于乳胶凝集实验法特异度56.5%,差异有统计学意义(P0.05)。结论脑脊液细胞学检查比传统的墨汁染色法及乳胶凝集实验有更高的灵敏度及特异度,且更直接,是一种先进快捷便利的检测方法。     

Cerebrospinal fluid lavage in the treatment of inadvertent intrathecal vincristine injection

Vincristine, a widely used antineoplastic agent, is extremely toxic to the central nervous system. If given intrathecally, it produces a rapidly ascending, usually fatal, neuromyeloencephalopathy. We report a case of this complication in a 7-year-old girl with acute lymphoblastic leukemia who was receiving maintenance chemotherapy. During one treatment 0.5 mg of vincristine was erroneously injected into the lumbar subarachnoid space. Cerebrospinal fluid lavage was established within 2 h and continued for 24 h. After 7 days she developed a progressive sensorimotor paraplegia, which eventually stabilized as a paraparesis. Neurophysiological studies were consistent with an axonal type sensorimotor neuropathy. Magnetic resonance imaging of the spine was normal. Vincristine binds to cells, blocking mitosis, thus causing cell death. The associated central nervous system lesions are those of an ascending chemical leptomeningitis and ventriculitis. Cerebrospinal fluid lavage dilutes and removes the drug, thus limiting neural damage. At present this is the only treatment for intrathecal vincristine injection, and its early use in such an event is considered mandatory. Received: 10 June 1998     

脑脊液净化治疗仪对模拟血性脑脊液体外净化效果的评价

目的 利用脑脊液净化治疗仪对模拟血性脑脊液进行体外净化试验,评价该净化仪的稳定性、滤过效率与滤过承载量,为进一步临床试验提供数据。方法 选择健康人悬浮红细胞及生理盐水配制成2.5%、5%、7.5%的模拟血性脑脊液,脑脊液净化仪及配套的管路系统采用自行研制并获国家专利的产品,将此种模拟血性脑脊液按照未来人体试验的模式进行脑脊液净化仪的体外净化试验,净化参数设置参照正常人体脑脊液循环的生理指标,分析净化前后红细胞计数的变化。结果 在滤膜最大承载试验中,2.5%模拟血性脑脊液的红细胞去除率达到90%以上时需要的循环总量达到330 ml,而5%、7.5%模拟血性脑脊液所需要的循环总量分别为390 ml、420 ml。在红细胞去除率达95%以上时,2.5%、5%、7.5%模拟血性脑脊液所需循环总量分别为390 ml、450 ml、480 ml。在体外模拟人体环境的净化效果试验中,2.5%模拟血性脑脊液单套滤膜净化循环6次后红细胞平均数由153 000个/mm3,下降到63 900个/mm3,下降率超过55%。结论 脑脊液净化仪能够有效去除模拟血性脑脊液中的红细胞,设备的稳定性高。     

Histamine in Cerebrospinal Fluid of Children with Febrile Convulsions

Summary: Febrile convulsions (FC) are frequent acute neurologic disturbances of childhood. The cellular and neurochemical mechanisms causing FC are unclear. Among other mechanisms, the CNS histamine (HA) has been suggested to participate in seizure control and thermoregulation. We evaluated the possible role of HA in regulation of FC by measuring HA and tele-methylhis- tamine (t–MH) concentrations in the cerebrospinal fluid (CSF) of children with FC. The study group consisted of 35 children treated for acute FC in the hospital. The control groups consisted of (a) feverish children without seizures ( n =23), (b) convulsive children without fever ( n =7), and (c) children with neither fever nor convulsions ( n =21). HA was assayed by high-performance liquid chromatography (HPLC) with fluorescence detection, and t-MH was measured by gas chromatography-mass spectrometry. CSF HA concentration in the group of febrile Convulsions occur rather frequently in connection with febrile children without seizures was significantly higher (0.69 ± 0.16 pmol/ml, mean k SE) than in children with FC (0.36 ± 0.07 pmol/ml, p <0.05, analysis of variance, ANOVA). HA concentration was 0.37 ± 0.18 pmoVml in the group of nonfebrile convulsive children and 0.36 k 0.08 pmol/ml in the nonfebrile nonconvulsive group. No statistical differences in t–MH were detected between groups. The increased susceptibility to seizures during fever may be connected to the lack of increase in CSF HA in the FC group. The data support the hypothesis that the central histaminergic neuron system may be involved in inhibition of seizures associated with febrile illnesses in childhood.     

儿童脑脊液与血浆生长抑素的相关性研究

采用放射免疫方法测定非神经系统疾患小儿脑脊液、血浆生长抑素(somatostatin,SS)含量,以探讨儿童脑脊液、血浆生长抑素的含量是否存在相关性。实验结果证明:脑脊液与血浆SS的含量无显著相关性(r=-0.237,P>0.10),提示SS含量不能间接反映脑脊液SS水平。     

原发性中枢神经系统淋巴瘤(附3例报道)

目的原发性中枢神经系统淋巴瘤很少见,本文报道3例原发性中枢神经系统淋巴瘤,以提高人们对本病的认识.方法回顾性分析3例患者的临床资料.结果2例患者临床以半身无力为主要症状,头颅CT、MRI检查示占位性病变,其中1例多发(3个病灶),1例单发.分别经脑活检和手术病理证实为淋巴瘤.1例患者首发症状为双侧视力障碍伴双下肢无力,经头颅CT、MRI检查未见异常,经脑脊液细胞学检查及免疫分型,诊断为淋巴细胞瘤.结论中枢神经系统淋巴瘤,特别是侵犯脑膜而非脑实质时,影像学检查有时也很难确诊,脑脊液细胞学检查为这些患者提供了可靠的临床诊断方法.     

Cerebrospinal fluid immunoglobulins in sheep with visna, a slow virus infection of the central nervous system

Icelandic sheep were injected intracerebrally with visna virus, which produces a persistent infection of the CNS accompanied by encephalomyelitis and focal demyelinating lesions. Studies were conducted on two groups of sheep, with short-term infections (25 sheep sampled 1–3 months after infection) and long-term infections (14 sheep sampled 5–6 years after infection). Quantitative determination of CSF immunoglobulin levels 5 years after infection indicated that IgM concentrations was usually elevated, IgG2 was occasionally elevated and IgG1 was rarely elevated. CSF oligoclonal bands were seen in about half the sheep examined 5 years after infection. There was a correlation between high titers of CSF antiviral antibody and both elevated CSF IgM concentration and CSF oligoclonal bands. Serum/CSF IgG1 ratios indicated that the blood-brain barrier was apparently intact in long-term visna infection, consistent with intrathecal synthesis of IgM and of antiviral antibody. The alterations in CSF immunoglobulins in visna resemble those found in other persistent CNS virus infections and in multiple sclerosis.     

兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察

目的 在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通,脑脊液经此途径回流到淋巴系统.方法 采用在兔枕大池内注射Microfil 的方法,在大体和光镜下观察灌注物质的分布.结果 显微镜下观察见Microfil 在枕大池、矢状窦、嗅球、筛板区域聚集分布,穿过筛板,使嗅黏膜淋巴管明显染色呈黄色,并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管;光镜下见Microfil 沿嗅神经走行,广泛分布在嗅黏膜的淋巴管内.结论 在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径,对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义.