脑脊液腺苷脱氨酶水平对结核性脑膜炎的诊断价值  

Diagnostic value of adenosine deaminase level in cerebrospinal fluid for tuberculous meningitis

作　　者：刘荣[1] 王丹[1] 李忠梅[1] 杜佳菊 熊海军 LIU Rong;WANG Dan;LI Zhong-mei(Department of Laboratory,Fukuang General Hospital of Liaoning Health Industry Group(Seventh Clinical College of China Medical University),Fushun Liaoning 113008,China)

机构地区：[1]辽宁省健康产业集团抚矿总医院检验科(中国医科大学第七临床学院)

出　　处：《临床和实验医学杂志》2020年第1期73-76,共4页Journal of Clinical and Experimental Medicine

基　　金：辽宁省自然科学基金指导计划项目(编号:20180550670)

摘　　要：目的探讨脑脊液中腺苷脱氨酶(ADA)对结核性脑膜炎的诊断价值以及不同时期的脑脊液ADA改变。方法采用回顾性研究方法,选取2017年8月至2019年6月辽宁省健康产业集团抚矿总医院收治的疑似结核性脑膜炎患者124例,按照诊断结果不同将患者分为两组:结核性脑膜炎组(n=92)和非结核性脑膜炎组(n=32)。分析两组患者的临床资料,包括脑脊液检测指标、脑脊液ADA诊断有效性以及不同时期的脑脊液ADA水平。结果结核性脑膜炎组患者的脑脊液蛋白含量(1.13±0.62 g/L vs.0.60±0.24 g/L)、细胞计数[(87.9±14.25)×10^9/L vs.(12.43±5.84)×10^9/L]、ADA水平(5.58±1.29 U/L vs.2.24±0.34 U/L)与非结核性脑膜炎组相比明显升高,糖(2.23±0.64mmol/L vs.3.04±0.58 mmol/L)以及氯化物(115.8±6.9 mmol/L vs.121.4±3.17 mmol/L)含量均明显降低,差异均具有统计学意义(P<0.05)。脑脊液中ADA水平诊断结核性脑膜炎的敏感度为97.65%,特异度为76.92%,阳性率为90.22%,诊断符合率为91.13%。结核性脑膜炎在治疗4、8周以及6个月后的脑脊液ADA水平与蛋白水平均相比治疗前明显降低,差异具有计学意义(P<0.05)。治疗6个月后的脑脊液ADA水平与蛋白水平相比治疗4、8周后明显降低,差异具有统计学意义(P<0.05)。结论结核性脑膜炎患者的脑脊液ADA水平明显较高,检测脑脊液中ADA水平有助于结核性脑膜炎的诊断。Objective To investigate the diagnostic value of adenosine deaminase(ADA)in cerebrospinal fluid(CSF)of patients with tuberculous meningitis and the changes of ADA in CSF at different periods.Methods A retrospective study was conducted to select 124 patients with suspected tuberculous meningitis admitted to the General Hospital of Liaoning Provincial Health Industry Group from August 2017 to June2019.The patients were divided into two groups according to the diagnosis results,including tuberculous meninges inflammatory group(n=92)and non-tuberculous meningitis group(n=32).The clinical data of the two groups of patients were analyzed,including cerebrospinal fluid test indicators,the effectiveness of cerebrospinal fluid ADA diagnosis and cerebrospinal fluid ADA levels in different periods.Results Cerebrospinal fluid protein content(1.13±0.62 g/L vs.0.60±0.24 g/L),cell count[(87.9±14.25)×10^9/L vs.(12.43±5.84)×10^9/L],ADA level(5.58±1.29 U vs.2.24±0.34 U)in patients with tuberculous meningitis/L)was significantly higher than non-tuberculous meningitis group,the content of sugar(2.23±0.64 mmol/L vs.3.04±0.58 mmol/L)and chloride(115.8±6.9 mmol/L vs.121.4±3.17 mmol/L)were significantly lower,the differences were statistically significant(P<0.05).The sensitivity of diagnosis of tuberculous meningitis was 97.65%,the specificity was 76.92%,the positive rate was 90.22%,and the diagnostic coincidence rate was 91.13%.The ADA level of cerebrospinal fluid in tuberculous meningitis after 4,8 and 6 months of treatment was significantly lower than that before protein treatment,and the difference was statistically significant(P<0.05).The ADA level of cerebrospinal fluid after 6 months of treatment was significantly lower than that of protein at 4 and 8 weeks after treatment,and the difference was statistically significant(P<0.05).Conclusion The level of CSF ADA in patients with tuberculous meningitis is obviously higher.Detection of ADA level in cerebrospinal fluid is helpful for the diagnosis of tuberculous meningitis.

关 键 词：结核性脑膜炎 脑脊液 腺苷脱氨酶 

分 类 号：R529.3[医药卫生—内科学]