流行性乙型脑炎患儿脑脊液中NSE、LDH、CPK、AST的改变分析

目的探讨流行性乙型脑炎(乙脑)患儿脑脊液中神经元特异性烯醇酶(NSE)、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CPK)、天门冬氨酸氨基转移酶(AST)4种酶含量的变化及其临床意义。方法在治疗前分别采集乙脑患儿50例,化脓性脑膜炎(化脑)患儿脑脊液51例和正常儿童31例(对照组)脑脊液标本,用时间分辨免疫荧光法测定NSE,用酶连续速率法测定LDH、CPK、AST。结果乙脑组NSE水平显著高于化脑组和对照组(P均<0.01)。乙脑组和化脑组CPK及AST水平高于对照组(P<0.01或0.05),而化脑组CPK、LDH、AST水平明显高于乙脑组(P均<0.01)。乙脑患儿脑脊液中NSE水平随着临床分型而升高(P均<0.01)。结论对脑脊液进行NSE、LDH、CPK、AST检测,有助于诊断和鉴别诊断乙脑和化脑,并有助于判断乙脑脑损伤的程度和预后。

Clinical implications of the fluctuation of NSE,LDH,CPK and AST in cerebral-spinal fluid(CSF) in children with epidemic B-type encephalitis

Objective To outline the clinical significances of the changes of neuron specific enolase(NSE),lactate dehydrogenase(LDH),creatine phosphokinase(CPK) and aspartate aminotransferase(AST) in children with epidemic B-type encephalitis(EBE).Methods Before treatment,the cerebral spinal fluid(CSF) samples were collected from 50 children with EBE,51 children with epidemic purulent meningitis(PM) and 31 normal children(the control group).A time-resolved fluoroimmunoassay was used to detect NSE,an enzyme rate method was used to determine LDH,CPK and AST.Results In the EBE group,the NSE level was significantly higher than those in the PM group and the control group(P<0.01).In the EBE group and the PM group,the CPK and AST levels were significantly higher than those in the control group(P<0.01 or 0.05).And in the PM group,CPK,LDH and AST levels were significantly higher comparing to the EBE group(P<0.01).In children with EBE,NSE elevated as the classification worsened(P<0.01). Conclusion The measurement of NSE,LDH,CPK and AST in the CSF can help to diagnose and differentially diagnose EBE and PM,and can predict the progression of EBE.