三种脑部炎症病变脑脊液铁蛋白、脑脊液白蛋白/血清白蛋白比值和免疫球蛋白的变化及意义

目的　探讨结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化及诊断意义。方法　检测结核性脑膜炎 31例、病毒性脑膜炎 32例、急性播散性脑脊髓炎 30例患者的脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化 ,并与 30例正常者作对照。结果　方差分析显示结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎及对照组脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P <0 .0 0 0 1) ,3组脑部疾病间的铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P均 <0 .0 5 )。方差分析结核性脑膜炎、病毒性脑膜炎及急性播散性脑脊髓炎脑脊液IgA、IgM、IgG变化差异有统计学意义 (P <0 .0 0 0 1) ,结核性脑膜炎组脑脊液IgA、IgM较急性播散性脑脊髓炎及病毒性脑膜炎显著升高(P <0 .0 5 ) ,急性播散性脑脊髓炎IgG较结核性脑膜炎及病毒性脑膜炎显著升高 (P <0 .0 5 )。结论　结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值和脊液免疫球蛋白的变化和差异 ,可作为诊断和鉴别诊断的参考指标。

Change and significance of ferritin in cerebral spinal fluid,CSF/serum albumin ratio in three cerebral inflammation diseases

Objective To study the significance of the changes of ferritin in cerebral spinal fluid(CSF) and CSF/serum of albumin ratio and immunoglobulin(Ig) in diagnosis of tuberculous meningitis and viral meningitis and acute disseminated encephalomyelitis (ADEM). Methods The ferritin in CSF and the albumin ratio in CSF and serum and immunoglobulin in CSF were tested in 31 tuberculous meningitis and 32 viral meningitis and 30 ADEM patients and 30 controls. Results The analysis of variance showed that the ferritin in CSF and the CSF/serum albumin ratio with tuberculous meningitis, viral meningitis, ADEM and controlled group were significantly different(P< 0.0001).The SNK-q text shpwed that the ferritin in CSF and the CSF/serum albumin ratio in three cerebral infective diseases were significantly different(P< 0.05). The analysis of variance of immunoglobulin in CSF showed that the IgA,IgG and IgM in three cerebral infective diseases and controlled group were significantly different(P< 0.0001). The SNK-q text shpwed that the IgA and IgM in tuberculous meningitis were significantly higher than viral meningitis and ADEM(P< 0.05),the IgG in ADEM was higher than viral meningitis and tuberculous meningitis(P< 0.05). Conclusions The changes and the difference of the ferritin in CSF and the CSF/serum albumin ratio and immunoglobulin in CSF with tuberculous meningitis and viral meningitis and ADEM can be used as the referent criterion in diagnosis and differential diagnosis of three acute cerebral diseases.