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脑脊液(CSF)的化学分析和细胞计数对决定中枢神经系统感染是有帮助的,但不是经常可以明确鉴别病因是细菌还是病毒.特别是在腰穿前已开始了抗菌治疗的病例.最近有些报告指出一种既简单又迅速的试验方法,即测定CSF中乳酸的浓度,可以准确区别这两种病原体所致的脑膜炎.Brook等研究了97例根据发热和神经系统体征拟诊为中枢神经系统感染的病例,所有病例均作了CSF的白细胞、多核细胞计数,测定了糖、蛋白和乳酸浓度,并作了革兰氏染色和细菌培养.其中25例各项结果正常者作为对照组,26例CSF蛋白定量及白细胞增加,但革兰氏染色及细菌培养阴性者,作为无菌性脑膜炎,可能是病毒感染,其余27例为细菌性脑膜炎,有些病例在第一次CSF检查前已开始
Chemical analysis and cell counting of cerebrospinal fluid (CSF) may be helpful in determining central nervous system infections, but it is not always clear whether the cause is bacterial or viral, especially in the setting of antibacterial therapy before lumbar puncture. Some recent reports Pointed out that a simple and rapid test method, that is, the determination of lactate concentration in CSF, can accurately distinguish between the two pathogens meningitis.Brook et al 97 studied on the basis of fever and neurological signs to be diagnosed with the central nervous system Infected cases, all cases were made of CSF leucocytes, multinucleated cells count, determination of sugar, protein and lactic acid concentrations, and made Gram stain and bacterial culture.Among them 25 cases of normal results as a control group, 26 Cases of CSF protein and leukocytosis, but Gram stain and bacterial culture negative, as aseptic meningitis, may be viral infection, and the remaining 27 cases of bacterial meningitis, and some cases before the first CSF examination Start