结核性脑膜炎患者脑脊液中腺苷脱氨酶的动态观察

目的　动态观察结核性脑膜炎患者脑脊液中腺苷脱氨酶的变化 ,以期对结核性脑膜炎的早期诊断和预后判断提供依据。方法　采用比色法动态检测 4 3例结核性脑膜炎患者脑脊液中腺苷脱氨酶活力的变化 ,并以 2 2例病毒性脑膜炎患者作为对照组。结果　 4 3例结核性脑膜炎患者酶活性较对照组明显升高 ,差异有统计学意义 (P <0 .0 5 ) ,治疗后 2周内结核性脑膜炎患者腺苷脱氨酶活力较其他时间明显增高 ,此后腺苷脱氨酶活力随治疗时间的延长呈进行性下降趋势。另外 8例有不同程度的神经系统并发症结核性脑膜炎患者呈现持续高水平。结论　检测脑脊液中腺苷脱氨酶是早期诊断结核性脑膜炎的一个简单而可靠的方法 ;动态观察腺苷脱氨酶还能对疾病的预后判断提供依据。

Dynamic study on activity of adenosine deaminase in cerebrospinal fluid from patients with tuberculous meningitis in adults

S: Objective Successively observe the change of adenosine deaminase(ADA) activity in cerebrospinal fluid(CSF)with tuberculosis meningitis(TBM) in order to provide evidence for earlier diagnosis and prognosis of TBM. Methods ADA in CSF of 43 cases with TBM were observed dynamidy by the colorimetric method, and 22 cases with viral meningitis served as control group. Results ADA in 43 patients with TBM was much higher than that in the control group(P< 0.05). An obvious rise in ADA was observed during the first two weeks of therapy(P< 0.05).Later,a progressive decline was observed. Other 8 patients appearing serious nervous system complications presented unusual increases in ADA during the course of the disease. Conclusion The study suggests that it is simple and reliable to detect ADA in CSF for earlier diagnosis of tuberculous meningitis. Furthermore, dynamic observation can provide reliance for prognosis of TBM.