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目的观察脑脊液腺苷脱氨酶(ADA)、神经元特异性烯醇化酶(NSE)在神经型布氏杆菌病的改变。方法选择16例神经型布氏杆菌病患者为病例组,16例健康志愿者为对照组。测定两组研究对象血、脑脊液ADA、NSE水平。观察病例组患者脑脊液检查结果 ,收集9例病例组患者血及脑脊液ADA数据与对照组比较,收集15例病例组患者血及脑脊液NSE数据与对照组比较。结果病例组患者8例脑脊液压力>180 mm H_2O(1 mm H_2O=0.0098 kPa=9.8 Pa),8例正常。9例病例组患者血ADA水平为(13.90±9.35)U/L,与对照组的(9.39±3.89)U/L比较差异无统计学意义(P>0.05);病例组脑脊液ADA水平为(18.38±8.94)U/L,高于对照组的(2.96±1.14)U/L,差异具有统计学意义(P<0.05)。15例病例组患者血NSE水平为(12.84±4.31)ng/ml,与对照组的(10.57±2.85)ng/ml比较差异无统计学意义(P>0.05);病例组患者脑脊液NSE水平为(47.97±22.09)ng/ml,高于对照组的(11.62±2.91)ng/ml,差异具有统计学意义(P<0.05)。结论神经型布氏杆菌病非特异的临床表现和广泛的临床综合征给明确诊断带来一定的困难,尤其非疫区医生容易漏诊误诊。如临床工作中遇到类似结核性脑膜炎的脑脊液表现,脑脊液ADA、NSE增高且抗结核治疗效果不佳时应重点排查神经型布氏杆菌病。
Objective To investigate the changes of cerebrospinal fluid adenosine deaminase (ADA) and neuron specific enolase (NSE) in neurogenic brucellosis. Methods Sixteen patients with neurogenic brucellosis were selected as case group and 16 healthy volunteers as control group. The levels of ADA and NSE in blood and cerebrospinal fluid of two groups were determined. The cerebrospinal fluid (CSF) test results of patients in the case group were observed. ADA data of blood and cerebrospinal fluid in 9 patients were collected to compare NSE data of blood and cerebrospinal fluid collected from 15 patients with control group. Results In 8 cases, the cerebrospinal fluid pressure was> 180 mm H 2 O (1 mm H 2 O = 0.0098 kPa = 9.8 Pa), and 8 cases were normal. The levels of ADA in blood of 9 cases patients were (13.90 ± 9.35) U / L, which were not significantly different from those of the control group (9.39 ± 3.89) U / L (P> 0.05) ± 8.94) U / L, higher than the control group (2.96 ± 1.14) U / L, the difference was statistically significant (P <0.05). The level of NSE in 15 patients was (12.84 ± 4.31) ng / ml, which was not significantly different from that in control group (10.57 ± 2.85) ng / ml (P> 0.05) 47.97 ± 22.09 ng / ml, higher than that of the control group (11.62 ± 2.91) ng / ml, the difference was statistically significant (P <0.05). Conclusion The nonspecific clinical manifestations and extensive clinical syndromes of Nibbrine-type brucellosis bring certain difficulties to the definite diagnosis. In particular, the doctors in non-epidemic areas are easily misdiagnosed and missed. Such as clinical experience similar to cerebrospinal fluid of tuberculous meningitis performance, cerebrospinal fluid ADA, NSE increased anti-TB treatment ineffective should focus on the investigation of nervous type brucellosis.