血清钠离子浓度、脑脊液结核分枝杆菌耐药基因及腺苷脱氨酶在早期老年结核性脑膜炎患者诊疗中的应用价值  

Application value of serum sodium,cerebrospinal fluid gene X-pert MTB/RIF,and ADA in the diagnosis and treatment of early elderly patients with tuberculous meningitis

作　　者：刘伯飞 刘广天 杨继黎 高翠竹 赵丽 王芳 左兴智 马瑛龙 杨正贵 LIU Bofei;LIU Guangtian;YANG Jili;GAO Cuizhu;ZHAO Li;WANG Fang;ZUO Xingzhi;MA Yinglong;YANG Zhenggui(Ningxia Medical University,Yinchuan 750004,Chian;Department of Critical Care Medicine,the Fourth People's Hospital of Ningxia,Yinchuan 750021,China;Department of Prevention and Treatment,the Fourth People's Hospital of Ningxia,Yinchuan 750021,China;D epartment of Laboratory Medicine,People's Hospital of Ningxia Autonomous Region,Yinchuan 750002,China;Department of Laboratory,the Fourth People's Hospital of Ningxia,Yinchuan 750021,China;Department of Administration Office,the Fourth People's Hospital of Ningxia,Yinchuan 750021,China)

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏回族自治区第四人民医院重症医学科,宁夏银川750021 [3]宁夏回族自治区第四人民医院防治科,宁夏银川750021 [4]宁夏回族自治区人民医院检验科,宁夏银川750002 [5]宁夏回族自治区第四人民医院检验科,宁夏银川750021 [6]宁夏回族自治区第四人民医院办公室,宁夏银川750021

出　　处：《宁夏医学杂志》2022年第6期500-503,共4页Ningxia Medical Journal

基　　金：宁夏重点研发基金项目(2020BEG03018)。

摘　　要：目的探讨血清钠离子浓度、脑脊液结核分枝杆菌耐药基因检测(Gene X-pert MTB/RIF)、脑脊液ADA在早期老年结核性脑膜炎患者诊疗中的应用价值。方法选取老年中枢神经系统感染患者99例,其中40例结核性脑膜炎患者为观察组,59例非结核性脑膜炎患者为对照组。对所有患者行血清钠离子的浓度、脑脊液结核分枝杆菌耐药基因检测及脑脊液腺苷脱氨酶(ADA)检测,分析比较2组检测结果,分析老年结核性脑膜炎患者临床特点及治疗前后检测结果。结果结核性脑膜炎组相比较非结核性脑膜炎组脑脊液ADA、脑脊液蛋白升高(P<0.05),脑脊液氯化物、血清钠离子的浓度降低(P<0.05);结核性脑膜炎组脑脊液结核分枝杆菌耐药基因检测阳性率明显高于脑脊液浓缩集菌抗酸菌检测及脑脊液结核菌培养(P<0.05);接受抗结核治疗1个月后,结核性脑膜炎组患者脑脊液ADA、脑脊液蛋白降低(P<0.05),脑脊液氯化物、血清钠离子的浓度升高(P<0.05)。结论老年结核性脑膜炎临床症状不典型,血清钠离子的浓度、脑脊液X-pert、脑脊液ADA在早期老年结核性脑膜炎患者中有一定的诊断价值,在临床诊疗工作中应得到高度重视。Objective To investigate the value of serum sodium,cerebrospinal fluid mycobacterium tuberculosis resistance gene testing(Gene X-pert MTB/RIF),and cerebrospinal fluid adenosine deaminase(ADA)in the diagnosis and treatment of elderly patients with early tuberculous meningitis.Methods 99 elderly patients with central nervous system infection were selected,including 40 patients with tuberculous meningitis as the observation group and 59 patients with non-tuberculous meningitis as the control group.The concentration of serum sodium and Gene X-pert MTB/RIF and ADA were detected and compared.The clinical characteristics of elderly patients with tuberculous meningitis and the results before and after treatment were analyzed.Results Compared with non-tuberculous meningitis group,the cerebrospinal fluid ADA and protein were higher(P<0.05),and cerebrospinal fluid chloride and serum sodium were lower in the tuberculous meningitis group(P<0.05).The positive rate of drug resistance gene detectiong of mycobacterium tuberculosis in cerebrospinal fluid was significantly higher than that of concentrated set antacid test and tuberculosis culture in cerebrospinal fluid(P<0.05).After receiving anti-tuberculosis treatment for one month,the levels of ADA and protein in the tuberculous meningitis group decreased(P<0.05),and and the concentrations of chloride in cerebrospinal fluid and sodium in serum increased(P<0.05).Conclusion The concentration of serum sodium,cerebrospinal fluid X-pert,and cerebrospinal fluid ADA have certain diagnostic value in early elderly patients with tuberculous meningitis,and should be highly valued in clinical diagnosis and treatment.

关 键 词：血清钠离子浓度 X-pert 老年人 结核性脑膜炎 

分 类 号：R529.3[医药卫生—内科学]