颅内感染性疾病脑脊液神经元特异性烯醇化酶和腺苷脱氨酶检测的临床意义

目的探讨颅内感染性疾病患者脑脊液神经元特异性烯醇化酶(NSE)水平和腺苷脱氨酶(ADA)活性的变化及其临床意义。方法分别用ELISA法和连续检测法对23例化脓性脑膜炎、26例结核性脑膜炎、28例病毒性脑膜炎患者的脑脊液NSE水平和ADA活性进行测定,并与对照组(22例)进行比较。结果①化脓性脑膜炎组(化脑组)及结核性脑膜炎组(结脑组)的脑脊液NSE水平较病毒性脑膜炎组(疱疹性)、对照组显著升高(均为p<0·001);②病脑组脑脊液NSE和ADA与对照组比较差异无统计学意义(p>0·05);③结脑组患者脑脊液中ADA活性明显高于化脑组、病脑组及对照组(p<0·001);④化脑组ADA较对照组和病脑组升高(p<0·05)。结论脑脊液NSE的水平测定可作为鉴别细菌性脑膜炎和病毒性脑膜炎的一项实验指标;而脑脊液ADA活性测定对结核性脑膜炎的诊断意义更大。因此,同步检测脑脊液NSE和ADA对颅内感染性疾病的诊断及鉴别诊断可能具有更好的临床应用前景。

The Clinical Significance of Detecting the Neuronspecific Enolase and Adenosine Deaminase in Cerebrospinal Fluid of Patients with Intracranial Infection Diseases

Objective To explore the clinical significance of neuron specific enolase( NSE) level and adenosine deaminase (ADA) activity change in the cerebrospinal fluid (CSF)of the patients with intracranial infection.Methods NSE level and ADA activity in the cerebrospinal fluid of 23 cases purulent meningitis,26 cases with tuberculous meningitis and 28 cases with viral meningitis were detected by ELISA and continuous-monitoring method,respectively. The results were compared with control group (22 case).Results ① NSE level of purulent meningitis group and tuberculous meningitis group were significantly increased than viral meningitis group and control group (p<0.001). ② No significant difference of NSE level and ADA activity between viral meningitis group and control group (p>0.05).③ADA activity of tuberculous meningitis group was significantly increased than purulent meningitis group, viral meningitis group and control group (p<0.001).④ADA activity of purulent meningitis group was higher than viral meningitis group and control group(p<0.005). Conclusion The determination of the NSE in cerebrospinal fluid can be used as an important parameter for identifying bacterial meningitis from viral meningitis, while determination of the ADA activity in cerebrospinal fluid is useful to the diagnosis in tuberculous meningitis. Co-detection of NSE level and ADA activity in CSF maybe has a better prospect in diagnose and differential diagnosis in intracranial infection.