目的:探讨脑脊液腺苷脱氨酶(ADA)、乳酸(LA)、乳酸脱氢酶(LDH)、C-反应蛋白(CRP)检测对成人不同病原颅内感染的诊断价值。方法:将84例成人颅内感染患者按照病原学检查结果分为细菌性感染组59例和结核性感染组25例,并选择同期入院治疗的颅脑外伤但未感染的患者40例为对照组,收集2ml脑脊液,采用终点比色法检测脑脊液LA、LDH含量,采用连续监测法检测脑脊液ADA的含量,采用免疫比浊法检测脑脊液CRP含量。按照脑脊液ADA、LA、LDH、CRP水平绘制受试者工作曲线(ROC),并计算各指标的ROC曲线下面积、最佳临界值和95%可信区间(95%CI)。结果:细菌性感染组和结核性感染组脑脊液ADA、LA、LDH、CRP含量显著高于对照组(P<0.05),细菌性感染组脑脊液ADA含量显著低于结核性感染组,脑脊液CRP含量显著高于结核性感染组(P<0.05),细菌性感染组和结核性感染组脑脊液LA、LDH含量差异无统计学意义(P>0.05)。ADA、LA、LDH、CRP诊断细菌性颅内感染的最佳临界点分别为1.93U/L、2.07mmol/L、27.18U/L、19.54mg/L,ROC曲线下面积分别为0.796、0.647、0.767、0.871,脑脊液CRP对细菌性颅内感染的诊断价值较高。ADA、LA、LDH、CRP诊断结核性颅内感染的最佳临界点分别为7.83 U/L、2.23 mmol/L、36.47 U/L、27.14mg/L,ROC曲线下面积分别为0.907、0.624、0.753、0.749,脑脊液ADA对结核性颅内感染的诊断价值较高。结论:颅内感染患者脑脊液ADA、LA、LDH、CRP显著升高,当脑脊液ADA≥7.83U/L时,对结核性颅内感染具有较高的诊断价值;当脑脊液CRP≥19.54mg/L时,对细菌性颅内感染具有较高的诊断价值。 Objective: To investigate the diagnostic value of cerebrospinal fluid adenosine deaminase (ADA), lactic acid (LA), lactate dehydrogenase (LDH) and C-reactive protein (CRP) Methods: According to the results of pathogen test, 84 cases of adult patients with intracranial infection were divided into bacterial infection group (n = 59) and tuberculosis infection group (n = 25). Forty patients with craniocerebral trauma who were hospitalized during the same period but not infected were selected as the control group The cerebrospinal fluid (CSF) was collected. The cerebrospinal fluid concentrations of LA and LDH were measured by end-point colorimetric assay. The content of ADA in cerebrospinal fluid was detected by continuous monitoring method. CRP level in cerebrospinal fluid was detected by immunoturbidimetry. Subjects working curve (ROC) were drawn according to cerebrospinal fluid ADA, LA, LDH and CRP levels, and the area under the ROC curve, the optimal threshold and the 95% confidence interval (95% CI) were calculated. Results: The contents of ADA, LA, LDH and CRP in cerebrospinal fluid were significantly higher in bacterial infection group and tuberculosis infection group than in control group (P <0.05). The ADA content in cerebrospinal fluid of bacterial infection group was significantly lower than that in tuberculosis infection group, (P <0.05). The contents of LA and LDH in cerebrospinal fluid in bacterial infection group and tuberculosis infection group had no significant difference (P> 0.05). The best cutoff points of ADA, LA, LDH and CRP in diagnosis of bacterial intracranial infection were 1.93U / L, 2.07mmol / L, 27.18U / L and 19.54mg / L respectively. The areas under ROC curve were 0.796,0.647, 0.767,0.871, cerebrospinal fluid CRP diagnosis of bacterial intracranial infection is higher. The best cut-off points of ADA, LA, LDH and CRP in diagnosing tuberculous intracranial infection were 7.83 U / L, 2.23 mmol / L, 36.47 U / L and 27.14 mg / L respectively. The areas under ROC curve were 0.907,0.624, 0.753,0.749, cerebrospinal fluid ADA diagnosis of tuberculous intracranial infection is higher. Conclusions: Cerebrospinal fluid ADA, LA, LDH and CRP were significantly increased in patients with intracranial infection. When ADA of cerebrospinal fluid was more than or equal to 7.83U / L, it had high diagnostic value for tuberculous intracranial infection. When CSF CRP was 19.54mg / L , Which has high diagnostic value for bacterial intracranial infection.