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。

Analysis of Clinical Data and CSF Cytology in Acute Viral Encephalitis

In 38 cases with acute viral encephalitis, analysis of clinical manifestation, changes in CSF, EEG and or was reported. The results showed that WBC counts in CSF in 50 percent of the patients were abnormally increased, and protein content increase in CSF was observed in 31. 6 percent of the patients, but the average values of sugar and chlorides contents in CSF were within normal ranges. The frequency of abnormality in CSF cytology was 94. 7 %. In the CSF the main responsive white bind cell types were small lymphocytes, activated lymphocytes and monocytes successively. Activated lymphocyte reaction was observed in 68. 4 percent of the patients, and lymphocyte monocyte reaction was in 10. 5 percent of the patients, but hared cell reaction, monocyte reaction and neutrophilic granulocyte reaction were individually in 5. 3 percent of the patients. Plasmocytes or eosinophilic granulocytes were rarely seen in the CSF. The rate of abnormalities in craniocerebral CT was 21. 1 %, and that in EEG was 60. 5 %. Based on the above findings it is concluded that CSF cytology examination is with advantages in sensitivity, eastness of observation, and stability,and this method is valuable for diagnosis of acute viral encephalitis.