脑脊液乳酸和腺苷脱氨酶检测在小儿脑膜炎中的诊断价值

目的探讨脑脊液乳酸和腺苷脱氨酶检测在小儿脑膜炎临床鉴别诊断中的应用价值。方法采用酶显色法检测脑脊液乳酸（LA）水平，酶动力学法检测脑脊液中腺苷脱氨酶（ADA）活性。结果化脓性脑膜炎（化脑组）和结核性脑膜炎（结脑组）脑脊液LA水平和ADA活性明显高于病脑组和对照组，差异均有统计学意义（P〈0．001）；化脑组脑脊液LA水平高于结脑组，两者比较差异有统计学意义（P〈0．05）；结脑组与化脑组脑脊液ADA活性差异有统计学意义（P〈0．001），且结脑组脑脊液ADA阳性率为83．33％（20／24），而化脑组脑脊液ADA活性水平均在正常范围内。病毒性脑膜炎（病脑组）脑脊液LA水平和ADA活性与对照组相比，差异均无统计学意义（P〉0．05）。结论脑脊液LA水平和ADA活性的同时检测，有助于小儿脑膜炎的临床鉴别诊断。

The diagnostic value of lactic acid and adenosine deaminase detection in cerebrospinal fluid of children with meningitis

Objective To investigate the clinical value of cerebrospinal fluid lactic acid (CSF-LA) and cerebrospinal fluid adenosine deaminase (CSF-ADA) detection in the diagnosis of meningitis in children. Methods Enzyme coloration method and enzymatic rate assay were used to determine the concentration of CSF-LA and the activity of CSF-ADA respectively. Results The levels of CSF-LA and CSF-ADA in purulent meningitis group and tubercular meningitis group were significantly higher than those in viral meningitis group and control group (P<0.001). CSF-LA level in purulent meningitis group was significantly higher than that in tubercular meningitis group (P<0.05). The difference of CSF-ADA level was significant between tubercular meningitis group and purulent group (P<0.001), and the positive rate of CSF-ADA in tubercular meningitis group was 83. 33% (20/24), whereas the CSF-ADA level in purulent meningitis was in normal range. The differences of CSF-LA and CSF-ADA levels between viral group and control group were not significant (P>0. 05). Conclusion The simultaneous detection of CSF-LA and CSF-ADA may be helpful for the clinical diagnosis of meningitis in children.