结核性脑膜炎脑脊液细胞学动态观察的临床意义

目的探讨脑脊液细胞学动态观察在结核性脑膜炎中的临床应用价值。方法通过脑脊液细胞学检测方法对43例结核性脑膜炎组及47例对照组进行动态观察，分析结核性脑膜炎在不同时期所具备的特点和持续的时间，并通过脑脊液细胞学演变过程的分析评估治疗的效果。结果典型的结核性脑膜炎早期呈以粒细胞增多为主的混杂细胞反应，治疗中期粒细胞逐渐减少，免疫细胞、激活单核细胞增多，治疗晚期以激活淋巴细胞反应为主，粒细胞逐渐消失，治愈后细胞学恢复正常，并可以此与化脓性脑膜炎、病毒性脑膜炎、隐球菌性脑膜炎等鉴别，对结核性脑膜炎的预后也有重要的指导意义。结论脑脊液细胞学的动态监测有助于结核性脑膜炎的早期快速诊断，并在结核性脑膜炎患者的预后判断上有一定价值。

Dynamic observation of cerebrospinal fluid cytology on tuberculous menigitis

S: Objective To discuss the clinical value of cerebrospinal fluid cytology dynamic observation on tuberculous menigitis.Medthods The dynamic detection of cerebrospinal fluid cytology was applied to 43 patients with tuberculous menigitis and 47 control patients,analysing the character and duration of different periods in tuberulous meningtis and assessing the curative effect were conducted through analysing cerebrospinal fluid cytology evolvement.Results The representive tuberculous menigitis in forepart showed intermix cytology reaction which had the most granulocytes.During the middle period of the treatment,granulocytes reduced and immune cells and active hyaline leukocytes increased.During the later period of the treatment,active lymphocytes reaction was the most obvious.Cerebrospinal fluid cytology was normal when tuberculous menigitis had becn cured.Different forms of tuberculous menigitis can be distingushed from purulent menigitis,cryptococal menigitis,viral menigitis and so on.That has important meaning to guide the prognostic of tuberculous menigitis.Conclusion Dynamic observation on cerebrospinal fluid cytology is helpful for earlier diagnosis of tuberculous menigitis.And the method has some value in judging the prognosis of the patients with tuberculous menigitis.