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目的探讨复查脑脊液(CSF)对CSF白细胞数>1000×106/L的病毒性脑炎、脑膜炎鉴别诊断的意义。方法将51例CSF白细胞数>1000×106/L的病毒性脑炎、脑膜炎作为试验组,102例CSF白细胞数<1000×106/L的作为对照组;两组给予对症治疗,不用抗菌药物,试验组2～3 d内复查CSF,如果白细胞数、蛋白质下降,继续原方案治疗。结果两组病情、疗程、治愈率差异无统计学意义,而CSF白细胞数、蛋白质差异有统计学意义;试验组两次CSF白细胞数、蛋白质差异有统计学意义。结论不用抗菌药物2～3 d内复查CSF,如果白细胞数、蛋白质下降支持病毒性脑炎、脑膜炎诊断,有助于鉴别诊断与抗菌药物合理使用。
Objective To investigate the significance of cerebrospinal fluid (CSF) in the differential diagnosis of viral encephalitis and meningitis with CSF leukocytes> 1000 × 106 / L. Methods 51 cases of viral encephalitis, meningitis with CSF leucocyte count> 1000 × 106 / L were used as experimental group and 102 cases with CSF leucocyte count <1000 × 106 / L as control group. The two groups were given symptomatic treatment without antimicrobial agents , The experimental group 2 ~ 3 d CSF review, if the number of white blood cells, protein decreased, continue the original program of treatment. Results There was no significant difference in disease, course of treatment and cure rate between the two groups, but CSF white blood cell count and protein difference were statistically significant. Conclusion There is no need to review the CSF within 2 ~ 3 days of antimicrobial drugs. If the white blood cell count and protein drop support the diagnosis of viral encephalitis and meningitis, it is helpful for the differential diagnosis and rational use of antimicrobial agents.