摘要
目的了解老年结核性脑膜炎患者脑脊液细胞学动态变化特点与临床的关系。方法 30例老年结核性脑膜炎患者经临床和辅助检查确诊,患者治疗前、治疗1、2和4周的脑脊液采用脑脊液细胞玻片离心沉淀法收集细胞,经瑞-姬染色后,在光学显微镜下进行细胞分类计数,轻度异常为白细胞总数〈50×10^6/L,中度异常为（50-200）×10^6/L,重度异常为〉200×10^6/L。并进行统计分析。结果 30例患者中,结核抗体阳性6例,结核菌素试验阳性11例。30例患者的脑脊液细胞学检查均有异常,其中轻度异常9例,中度异常18例,重度异常3例。有半数以上患者早期淋巴细胞比例明显增高（占54.8%）,以淋巴细胞为主的混合细胞反应占优势。与治疗前比较,治疗1周后患者脑脊液白细胞总数逐渐下降[（145.5±133.4）×10^6/L vs（250.2±185.3）×10^6/L,P〈0.05],而嗜中性粒细胞比例升高（P〈0.05）,治疗2和4周后患者白细胞总数下降更明显[（132.1±123.9）×10^6/L和（88.8±115.6）×10^6/L vs（250.2±185.3）×10^6/L,P〈0.05,P〈0.01]。结论脑脊液细胞的动态变化,对老年结核性脑膜炎的早期诊断和对病情监测及预后有着重要的临床意义。
Objective To study the relationship between characteristics of cerebrospinal fluid cytology and clinical features of elderly tuberculous meningitis patients.Methods White blood cells（WBC）were isolated from cerebrospinal fluid of 30 elderly tuberculous meningitis patients by centrifugal precipitation,stained with MGG,and calculated by optical microscopy before treatment and 1,2,4weeks after treatment.The number of WBC was defined as mildly,moderately and severely abnormal when it was50×10^6/L,（50-200）×10^6/L and 200×10^6/L.Results Cerebrospinal fluid cytometry showed that the WBC were mildly,moderately and severely abnormal respectively in 9,18 and 3out of the 30 patients.Dominant mixed cell reactions were observed in54.8% of the patients.The total number of WBC in cerebrospinal fluid was lower 2and 4weeks after treatment than before treatment whereas the number of neutrophils was higer 1week after treatment than before treatment（132.1±123.9）×10^6/L vs（250.2±185.3）×10^6/L,（88.8±115.6）×10^6/L vs（250.2±185.3）×10^6/L,P〈0.05,P〈0.01;（145.5±133.4）×10^6/L vs（250.2±185.3）×10^6/L,P〈0.05,P〈0.01）.Conclusion Cerebrospinal fluid cytology plays an impootant role in early diagnosis,progression and prognosis of tuberculous meningitics.
出处
《中华老年心脑血管病杂志》
CAS
2016年第1期64-66,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
结核
脑膜
脑脊髓液
细胞学
白细胞
早期诊断
tuberculosis
meningeal
cerebrospinal fluid
cytology
leukocytes
early diagnosis
