急性细菌性脑膜炎与病毒性脑膜炎的鉴别诊断

　　clinicallaboratory，generalhospitaloftianjinmedicaluniversity，tianjin300052，china

　　【abstract】objectivetostudymultiplelaboratorymarkerinthedifferentialdiagnosisofacutebacterialandviralmeningitis，andtrytodiscussitsclinicalvalue.methods29patientswithacutebacterialmeningitisand36patientswithviralmeningitiswereretrospectivelyanalyzed。clinicalsymptoms，peripheralbloodpicture，bloodglucose（glu），bloodc-reactiveprotein（crp）andthecerebrospinalfluid（csf）leukocytenumber，glucose（glu），protein（pro），lacticacid（la），lacticdehydrogenase（ldh），andc-reactiveproteinwerecomparedrespectively.resultsacutebacterialmeningitiswashardlydifferentiatedfromacuteviralonebyclinicalsymptomsandperipheralbloodpicture，butacutebacterialmeningitisshouldbehighlysuspectedinpatientswithincreasingofcsfleukocytes，csfpolymorphonuclearleukocytes，csflacticacid，csflacticdehydrogenase，csfc-reactiveproteinanddecreasingofcsfglucose.conclusiontherearediagnosisanddifferentialdiagnosisvaluesbetweenacutebacterialmeningitisandviralmeningitisbyexaminationabovelaboratorymarkerincsf.

　　【keywords】bacterialmeningitis；viralmeningitis；cerebrospinalfluid；differentialdiagnosis

　　典型的细菌性脑膜炎临床诊断并不困难，早期确诊和及时彻底治疗是降低病死率和后遗症发生率的关键，但急性细菌性脑膜炎临床表现难与病毒性脑膜炎相鉴别，为此，对29例细菌性脑膜炎和36例病毒性脑膜炎患者的临床表现、外周血象和脑脊液检测结果进行对比分析，以探讨各项实验室指标对鉴别两种脑膜炎的临床应用价值，现报告如下。