脑脊液置换联合鞘内注射治疗对结核性脑膜炎患者脑脊液CRP和NSE水平的影响  

Effect of cerebrospinal fluid replacement combined with intrathecal injection on C-reactive protein and neuron-specific enolase in patients with tuberculous meningitis

作　　者：张建树[1] 李倩[1] 孟艺哲 

机构地区：[1]河北省保定市第一中心医院东院检验科,071028 [2]河北省胸科医院神经内科,石家庄050048

出　　处：《检验医学与临床》2018年第2期164-167,共4页Laboratory Medicine and Clinic

基　　金：河北省青年科技课题资助项目(20150140)

摘　　要：目的探讨脑脊液置换联合鞘内注射治疗对结核性脑膜炎(TBM)患者脑脊液C反应蛋白(CRP)和神经元特异性烯醇化酶(NSE)的影响。方法选取2015年1月至2016年10月保定市第一中心医院收治的102例TBM患者作为研究对象,采用抽签法随机分为观察组(51例)和对照组(51例)。对照组患者给予抗结核、保肝、激素等常规治疗,观察组在接受常规治疗的基础上给予脑脊液置换联合鞘内注射治疗,对比分析两组患者治疗前后脑脊液CRP和NSE水平,以及治疗后的临床症状缓解情况和临床疗效。结果治疗前两组患者脑脊液CRP和NSE水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者脑脊液CRP和NSE水平均较治疗前降低,与对照组比较观察组下降更明显,观察组患者在头痛消失时间、发热消失时间、压力恢复时间、脑膜刺激征消失时间、脑脊液蛋白恢复时间及脑脊液细胞恢复所需时间均明显少于对照组,观察组总有效率为96.08%(49/51),明显高于对照组的80.39%(41/51),上述指标差异均有统计学意义(P<0.05)。结论 TBM患者应用脑脊液置换联合鞘内注射治疗可明显降低患者脑脊液CRP和NSE水平,且临床疗效显著,值得临床推广使用。Objective To investigate the effects of cerebrospinal fluid replacement and intrathecal injection on C-reactive protein and neuron-specific enolase in patients with tuberculous meningitis. Methods A total of 102 patients with tuberculous meningitis admitted in our hospital from January 2015 to October 2016 were en- rolled in this study. Fifty-one patients were divided into observation group and control group by method of drawing lots. The patients in the control group were given anti-tuberculosis and hepatoprotective, hormone and other conventional treatment,the observation group received conventional treatment based on the use of cere- brospinal fluid replacement combined with intrathecal injection treatment, the two groups of patients before and after treatment of C-reactive protein and neuron-specific enolase levels and clinical after treatment Symp- tom relief and clinical efficacy. Results There were no significant differences in CRP and NSE between the two groups before treatment （P〉0.05）. After treatment,the levels of CRP and NSE in the two groups were significantly lower than those in the control group. The recovery time of the headache, the time of disappear- ance of the fever,the time of recovery of the meningeal irritation,the recovery time of cerebrospinal fluid pro- tein and the time required for the recovery of cerebrospinal fluid were significantly better than those of the control group. The total effective rate was 96.08%（49/51）,which was significantly higher than that of the control group 80. 390/00 （41/51）, the above differences were statistically significant （P〈0. 05）. Conclusion The combination of cerebrospinal fluid replacement and intrathecal injection in patients with tuberculous men- ingitis can significantly reduce the levels of C-reactive protein and neuron-specific enolase, and the curative effect is significant. Worthy of clinical use.

关 键 词：结核性脑膜炎 脑脊液 鞘内注射 C反应蛋白 神经元特异性烯醇化酶 

分 类 号：R446.1[医药卫生—诊断学]