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目的探讨流行性脑脊髓膜炎(简称流脑)患者实验室检查的特点。方法分析2005年春季本院收治的41例确诊流脑患者的实验室检查结果。结果41例流脑患者外周血象白细胞及中性粒细胞显著升高,并在病程第3天达高峰,随后迅速下降,多在一周内恢复正常。血小板下降,其中血小板容积比下降明显。脑脊液白细胞及中性粒细胞亦显著升高,进入病程第2周后恢复。血清LDH、CK、CK-MB、ALT、AST等有不同程度的异常,分别为6例(14·63%)、14例(34·15%)、19例(46·34%)、16例(39·02%)、18例(43·90%),治疗后逐渐恢复。脑膜炎奈瑟氏菌(Nm)检出率为60·98%(25/41),病原菌对青霉素、氯霉素、复方磺胺及头孢曲松均敏感,部分对庆大霉素、红霉素耐药。结论患者临床表现及白细胞计数、脑脊液检查结果典型,部分患者生化结果异常,血小板容积比明显下降。早诊断、早治疗有助于患者预后且病原体检出率高,常用抗生素敏感。
Objective To investigate the characteristics of laboratory tests in patients with epidemic cerebrospinal meningitis (referred to as meningitis). Methods The laboratory results of 41 confirmed cases of meningitis in our hospital in spring of 2005 were analyzed. Results The peripheral blood leukocytes and neutrophils in 41 cases of patients with meningitis increased significantly and peaked on the third day of the course, then decreased rapidly and returned to normal in one week. Thrombocytopenia, including platelet volume ratio decreased significantly. Cerebrospinal fluid leukocytes and neutrophils were also significantly increased, into the course of the first 2 weeks after recovery. There were 6 cases (14.63%), 14 cases (34.15%), 19 cases (46.34%) and 16 cases (16.3%) of serum LDH, CK, CK-MB, ALT and AST, (39 · 02%), 18 cases (43 · 90%), gradually recovered after treatment. The positive rate of Neisseria meningitidis (Nm) was 60.98% (25/41). The pathogenic bacteria were sensitive to penicillin, chloramphenicol, sulfamethoxazole and ceftriaxone, and partly to gentamicin, erythromycin Resistance. Conclusion The clinical manifestations of patients and the white blood cell count, cerebrospinal fluid test results typical of some patients with abnormal biochemical results, platelet volume ratio decreased significantly. Early diagnosis, early treatment contribute to the prognosis of patients and the detection rate of pathogens, commonly used antibiotics sensitive.