成人脑脊液乳酸含量测定在结核性脑膜炎和病毒性脑膜炎鉴别诊断中意义.docVIP

成人脑脊液乳酸含量测定在结核性脑膜炎和病毒性脑膜炎鉴别诊断中意义 　　[摘要] 目的 分析?X脊液中乳酸含量在结核性脑膜炎和病毒性脑膜炎鉴别诊断中的意义，总结诊断经验。 方法 选取2014年7月～2016年7月本院神经内科收治结核性脑膜炎患者30例，病毒性脑膜炎患者30例，行脑脊液乳酸水平监测，进行数据分析。 结果 初次及第2次脑脊液检查，结核性脑膜炎组脑脊液乳酸高于病毒性脑膜炎组，结核性脑膜炎组GCS评分低于病毒性脑膜炎，差异有统计学意义（P0.05）。初次检查结核性脑膜炎、病毒性脑膜炎脑脊液乳酸与GCS评分存在相关性，第2次检查结核性脑膜炎存在相关性（P0.05）。第1次脑脊液乳酸鉴别诊断结核性脑膜炎以及病毒性脑膜炎灵敏度、特异度、阳性预测值、阴性预测值、符合率均高于第2次，差异有统计学意义（P0.05）。 结论 脑脊液中乳酸含量在结核性脑膜炎和病毒性脑膜炎鉴别诊断中有较高的价值，特别是初次检查结果，需要及早进行分析，脑脊液中乳酸含量还与疾病严重程度关系密切。 　　[关键词] 脑炎；结核性脑膜炎；病毒性脑膜炎；脑脊液；乳酸 　　[中图分类号] R446.1 [文献标识码] B [文章编号] 1673-9701（2017）34-0095-03 　　The significance of lactic acid determination in adult cerebrospinal fluid in the differential diagnosis of tuberculous meningitis and viral encephalitis 　　ZOU Dezhi 　　Department of Neurology， the First Affiliated Hospital of Chongqing Medical University， Chongqing 400016， China 　　[Abstract] Objective To analyze the significance of lactic acid in cerebrospinal fluid （CSF） in the differential diagnosis of tuberculous meningitis and viral encephalitis and to summarize the experience of diagnosis. Methods The lactic acid levels of 30 patients with tuberculous meningitis and 30 patients with viral meningitis admitted in our Hospital from July 2014 to July 2016 were monitored and the data were analyzed. Results The cerebrospinal fluid lactic acid in tuberculous meningitis group was higher than that in viral meningitis group in the first and second cerebrospinal fluid tests. The GCS score of tuberculous meningitis group was lower than that of viral meningitis， and the difference was significant（P0.05）. The lactic acid in tuberculous meningitis and viral cerebrospinal fluid in the initial examination had a correlation with GCS score. And the tuberculous meningitis in the second check had correlation （P0.05）. The sensitivity， specificity， positive predictive value， negative predictive value， coincidence rate of the first cerebrospinal fluid lactic acid differential diagnosis of tuberculous meningitis and viral meningitis were higher than those