CAJ | 학술논문

目的探讨血清乳酸脱氢酶(LDH)、肌酸激酶(CK)、天冬氨酸转氨酶(AST)及脑脊液乳酸脱氢酶(CSF LDH)检测在成人颅内感染患者急性期的变化及其临床意义.方法收集病毒性脑炎(病脑组)47例,结核性脑膜炎(结脑组)30例和化脓性脑膜炎(化脑组)19例及体检正常者(对照组)39例的血清标本,并收集颅内感染组的腰穿脑脊液.采用贝克曼全自动生化分析仪,以酶速率法测定所有标本的血清AST、LDH、CK以及患者CSF的LDH.结果 (1)颅内感染组血清心肌酶LDH、CK、AST水平均显著高于非感染组(P＜0.01).(2)根据有无瘫痪、抽搐、失语、昏迷等症状将脑膜炎患者分为障碍组和无障碍组,障碍组血清LDH、AST水平均明显高于无障碍组(P＜0.05).(3)病脑组血清AST、LDH、CK水平,化脑组血清AST、LDH水平及结脑组血清LDH水平均明显高于对照组(P＜0.01),结脑组和化脑组CSF LDH活性升高程度较病脑组高(P＜0.01).(4)直线相关分析颅内感染患者血清LDH与脑脊液LDH无相关(P＞0.05).结论 (1)成人颅内感染急性期存在明显的血清LDH、CK、AST及CSF LDH的改变,以LDH改变最为明显,在合并有脑功能障碍时LDH、AST改变更明显;(2)检测血清LDH、CK、AST和CSF LDH水平有助于颅内感染早期的鉴别诊断,以及判断病情的严重程度.
목적 탐토혈청유산탈경매(LDH)、기산격매(CK)、천동안산전안매(AST)급뇌척액유산탈경매(CSF LDH)검측재성인로내감염환자급성기적변화급기림상의의.방법 수집병독성뇌염(병뇌조)47례,결핵성뇌막염(결뇌조)30례화화농성뇌막염(화뇌조)19례급체검정상자(대조조)39례적혈청표본,병수집로내감염조적요천뇌척액.채용패극만전자동생화분석의,이매속솔법측정소유표본적혈청AST、LDH、CK이급환자CSF적LDH.결과 (1)로내감염조혈청심기매LDH、CK、AST수평균현저고우비감염조(P＜0.01).(2)근거유무탄탄、추휵、실어、혼미등증상장뇌막염환자분위장애조화무장애조,장애조혈청LDH、AST수평균명현고우무장애조(P＜0.05).(3)병뇌조혈청AST、LDH、CK수평,화뇌조혈청AST、LDH수평급결뇌조혈청LDH수평균명현고우대조조(P＜0.01),결뇌조화화뇌조CSF LDH활성승고정도교병뇌조고(P＜0.01).(4)직선상관분석로내감염환자혈청LDH여뇌척액LDH무상관(P＞0.05).결론 (1)성인로내감염급성기존재명현적혈청LDH、CK、AST급CSF LDH적개변,이LDH개변최위명현,재합병유뇌공능장애시LDH、AST개변경명현;(2)검측혈청LDH、CK、AST화CSF LDH수평유조우로내감염조기적감별진단,이급판단병정적엄중정도.
Objective To investigate the changes and clinical significance of serum lactate dehydrogenase (LDH),creatine kinase (CK),glutamate pyruvate transaminase (AST),and cerebrospinal fluid lactate dehydrogenase (CSF LDH) in adult patients with acute central nervous system infection.Methods The levels of myocardial enzymes (AST,LDH,and CK) in serum of 96 adult patients with acute intracranial infection in 7days and 39 healthy people were measured by Beckman automatic biochemical analyzer and enzyme rate assay,and CSF LDH level in 96 patients were measured simultaneously.Results (1) The serum myocardial enzymes (LDH,CK,and AST) of intracranial infection group (47 cases with viral encephalitis,30 cases with tuberculous meningitis,and 19 cases with purulent encephalitis) were significantly higher than those of normal control group (P ＜0.01).(2)The myocardial enzymes (LDH,and AST ) of patients with cerebral functional disorder were significantly higher than those of patients with normal cerebral function (P ＜0.05).(3)The levels of serum AST,LDH,and CK in the virus encephalitis group,serum AST and LDH in the purulent encephalitis group,and serum LDH in the tuberculous meningitis group were significantly higher than those in the control group (P ＜ 0.01).The CSF LDH level in the viral meningitis group was prominently lower than that in the tuberculous encephalitis group and purulent encephalitis group,respectively (P ＜0.01).(4) No correlations were found between CSF LDH and serum myocardial enzymes (P ＞0.05).Conclusions (1)There is significant change in the levels of serum LDH,CK,AST,and CSF LDH of adult patients with acute intracranial infection,especially in infected patients with cerebral functional disorder,and the change of LDH is the most obvious.(2)The levels of serum myocardial enzymes and CSF LDH are helpful to the differential diagnosis of intracranial infection in early stage,and judging the severity of the illness.