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目的 :探讨提高脑脊液 (CSF)结核杆菌 (MTb)培养阳性的规律 ,对结核性脑膜炎 (TBM )发病不同时期多项检查参数动态观察比较 .方法 :根据不同病程将病人分为 3组 ,A组 (发病 <2周 ) ,B组 (2周～ 1月 ) ,C组 (>1月 ) .对各项检查数据进行动态观察比较 .结果 :A组MTb培养阳性 4例 ,其中侧脑室穿刺 2例MTb培养均呈阳性 ,腰穿 13例只有 2例阳性 ,B组和C组培养阴性 .3组病人CSF蛋白含量持续增高不变 .A组与C组间CSF葡萄糖含量差异有高度显著性 (P <0 0 1) ,B组与C组间差异有显著性 (P <0 0 5 ) ,A组与B组间差异无显著性 (P >0 0 5 ) ,表明发病 2周后CSF葡萄糖含量开始增加 .A组与C组间CSF氯化物含量差异有显著性 (P <0 0 5 ) ,A组与B组间 ,B组与C组间差异无显著性 (P >0 0 5 ) ,表明发病 1月后CSF氯化物含量逐渐增加 .CSF白细胞计数逐渐恢复正常 ,细胞学渐呈慢性炎症特点 ,A组与B组间 ,A组与C组间 ,以及B组与C组间差异有高度显著性 (P <0 0 1) ,表明经过治疗后 ,CSF白细胞数逐渐恢复正常 .头颅影像学改变差异无显著性 .结论 :早期 (2周内 )取CSF有助MTb培养阳性 .CSF蛋白持续增高有助于免疫学诊断 .葡萄糖、氯化物、白细胞计数及细胞学变化可做为判断疾病恢复或迁延的依据 .头颅影像学有助诊断
Objective: To explore the rule of increasing the positive culture of MTb in cerebrospinal fluid (CSF) and to observe the dynamic changes of multiple check-up parameters of tuberculous meningitis (TBM) in different periods.Methods: The patients were divided into three groups according to different course of disease: A Group B (2 weeks to January), Group C (> 1 month) .All the data of the test were observed and compared.Results: In group A, MTb culture was positive in 4 cases, in which lateral ventricle puncture 2 cases of MTb culture were positive, only 13 cases of lumbar puncture positive in 2 cases, negative culture in group B and group C. The CSF protein content of 3 patients continued to increase unchanged .A group and group C CSF glucose content was highly significant (P <0.01). There was significant difference between group B and group C (P <0.05), but there was no significant difference between group A and group B (P> 0.05), indicating that CSF (P <0.05), there was no significant difference between group A and B, group B and group C (P> 0.05) ), Indicating that CSF chloride content gradually increased after 1 month of onset.CSF white blood cell count gradually returned to normal, cytology gradually showed chronic inflammation characteristics, between A group and B group, A group and C group, And the difference between group B and group C was highly significant (P <0.01), indicating that after treatment, the number of CSF white blood cells gradually returned to normal. There was no significant difference in the change of cephalic imaging.Conclusion: CSF positive MTb culture positive.CSF proteins continue to increase immunological diagnosis.Glucose, chloride, white blood cell count and cytological changes can be used as a basis to determine the recovery or prolongation of the disease.Craniography can help diagnose