SU1406482A1 - Method of differential diagnostics of suppurative and serous meningitis - Google Patents

Abstract

The invention relates to medicine, more specifically to an infectious pathology, intended for the differential diagnosis of purulent and serous meningitis. The purpose of the invention is improving the accuracy of diagnostics by determining the activity of alkaline phosphatase ({F in the cerebrospinal fluid (CSF)). For this, the patient is taken SS, centrifuged for 10 minutes at 3000 rpm. Umin, 0.2 ml of supernatant is added to 0.3 ml of subprate - diammonium salt of p-nitrophenylphosphate with glucose (1 mg of mixture / ml of p-ra buffer - mixture of base to DN-methylglucamine hydrochloride with sulfuric acid magnesium) and incubated for 30 min at 37 ° C. Then add 2 ml of inhibitor

Description

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The invention relates to medicine, namely to an infectious pathology, and can be used for the differential diagnosis of purulent and serous meningitis.

The purpose of the invention is to improve the accuracy of diagnosis by determining the activity of alkaline phosphatase

Establish a diagnosis of serous meningitis. The generally accepted analysis of CSF showed abnormality: the Pandy reaction - the Nonne-Apelt reaction - “- f-, protein 0.33 g / l, cytosis 648 cells / µl, neutrophils 60%, lymphocytes 40%. After a comprehensive clinical examination The patient was lung (alkaline phosphatase) in the cerebrospinal fluid (CSF). The diagnosis of epidemic parotitis.

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The method is carried out as follows.

The cerebrospinal fluid is taken from the patient, centrifuged for 10 minutes at 3000 rpm, 0.2 MP of the supernatant is added to 0.3 MP of the subprate — p-nitrophenylphosphate-diammonium salt with glucose (1 mg of the mixture / ml of buffer solution). - mixtures of the base and hydrochloride of 1) -H-methylglucamine with magnesium sulfate) and incubated at 37 ° C for 30 minutes. Then, the mixture is added with 1 Ib.avl. 2 MP inhibitory 0.7 M hydro-. Sodium hydroxide and O, M complex III); And the optical density is determined at 25: 405 them. With the activity of alkaline phosphatase of 3.5 U / l and above, purulent meningitis is diagnosed, and with the activity of alkaline phosphatase of 2.5 U / l and below - I serous meningitis. ; Example 1. Patient B., i5 years old, was admitted to the hospital on.:. : Disease Day with a diagnosis of Epidemic: parotid parotiditis, serous meningitis. The disturbance began with the temperature, increasing the parotid glands. In the following days, pain in the region of the salivary glands appeared, and the appetite worsened. On the same day, the salivary glands decreased in size, but there was headache: pain, vomiting, a high temperature was maintained. On admission, the state of average gravity, pulse 100 beats / min HELL 120/80 mm Hg. Meningeal syndrome is pronounced. A lumbar puncture was made on the day of admission. The NL was centrifuged at 3,000 rpm, over 10 minutes, 0.2 ml of the supernatant was added to 0.3 ml of the substrate to be boiled and incubated

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serous meningitis.

P R: I M e r 2. Ill H ,, 30 years old, admitted to hospital with a diagnosis of purulent meningitis. The disease began with an increase in temperature, headache, and vomiting. Upon admission, the state is severe, the pulse is 98 beats / min HELL 130/90 mm Hg. Meningeal syndrome is pronounced. Made lumbia puncture. CSF was centrifuged at 3000 rpm for 10 min. The alkaline phosphatase activity was determined to be 7.5 U / l in the supernatant, which made it possible to establish the diagnosis: Purulent meningitis. In the CSF, Pandi reaction + 4-f, None-Appelta, protein 0.33 g / l, cytosis 433 cells / µl, neutrophils 86%, lymphocytes 14%.

Diagnosis: Post-traumatic sepsis, septicopyemia, hyio-meningitis, in 51 patients with purulent meningitis

The activity of alkaline phosphatase in the CSF was:

22.0; 13.5; 7.5; 9.0; 11.0; 15.0;

3.7; 20.5; 10.5; 17.0; 5.0; 12.5;

I2.5; I6.0; 7.5; 6.0; 7.5; 21.5; 20.5; U, 5

20.5; 6.7; 8.2; 17.0; 15.5; 16.7;

17.5; 13.5; 18.5; 7.6; 9.6; 21.0;

19.6; 19.0; 18.7; 19.5; 17.5; 13.2;

14.5; 15.5; 6.7; 9.5; 8.5; 7.0;

6.7; 9.0; 14.5; 15.5; 16.5; 17.0; ,

18.2 U / L, and in 26 patients with serous

meningitis 3, 0; 1.5; 1.7; 2.9; 1.5; 0.5; 0.5;

1.5; 1.0; 0.5; 0,0; 0.5; 1.0; 2.0;

0,0; 1.0; 1.0; 1.0; 2.5; 2.8; 0.5;

1.5; 1.5; 2.0; 1.5; 0.5 U / L

The proposed method improves the accuracy of differential diagnosis.

27% compared to the known.

Claims (2)

Invention Formula the mixture at 37 ° C for 30 minutes in a water bath. Then 2: ml of inhibitor was added and the extinction of the solution was determined with a spectrophotometer at a wavelength of 405 them against the inhibitory solution. Distilled water instead of LF served as control. The activity of alkaline phosphatase: the supernatant part of the CSF was 1.5 U / l, which made it possible to establish the diagnosis of serous meningitis. The generally accepted analysis of CSF showed abnormalities: the Pandy reaction, the Nonne-Apelt reaction - "- f-, protein 0.33 g / l, cytosis 648 cells / µl, neutrophil 60%, lymphocytes 40%. After a comprehensive clinical The patient was diagnosed with Mumps. five 0 five 0 five 0 five 0 five serous meningitis. P P: And MER 2. Ill H ,, 30 years old, was admitted to hospital with a diagnosis of purulent meningitis. The disease began with an increase in temperature, headache, and vomiting. Upon admission, the state is severe, the pulse is 98 beats / min HELL 130/90 mm Hg. Meningeal syndrome is pronounced. Made lumbia puncture. CSF was centrifuged at 3000 rpm for 10 min. The alkaline phosphatase activity was determined to be 7.5 U / l in the supernatant, which made it possible to establish the diagnosis: Purulent meningitis. In the CSF, Pandi reaction + 4-f, None-Appelta, protein 0.33 g / l, cytosis 433 cells / µl, neutrophils 86%, lymphocytes 14%. Diagnosis: Post-traumatic sepsis, septicopyemia, hyio-meningitis, in 51 patients with purulent meningitis The activity of alkaline phosphatase in the CSF was: 22.0; 13.5; 7.5; 9.0; 11.0; 15.0; 3.7; 20.5; 10.5; 17.0; 5.0; 12.5; I2.5; I6.0; 7.5; 6.0; 7.5; 21.5; 20.5; U, 5; 20.5; 6.7; 8.2; 17.0; 15.5; 16.7; 17.5; 13.5; 18.5; 7.6; 9.6; 21.0; 19.6; 19.0; 18.7; 19.5; 17.5; 13.2; 14.5; 15.5; 6.7; 9.5; 8.5; 7.0; 6.7; 9.0; 14.5; 15.5; 16.5; 17.0; , 18.2 U / L, and in 26 patients with serous meningitis 3, 0; 1.5; 1.7; 2.9; 1.5; 0.5; 0.5; 1.5; 1.0; 0.5; 0,0; 0.5; 1.0; 2.0; 0,0; 1.0; 1.0; 1.0; 2.5; 2.8; 0.5; 1.5; 1.5; 2.0; 1.5; 0.5 U / L The proposed method improves the accuracy of differential diagnosis. 27% compared to the known. Invention Formula The method of differential diagnosis of purulent and serous meningitis by taking a sample of cerebrospinal fluid and determining the enzyme activity in it, characterized in that, in order to improve the diagnosis, the cerebrospinal fluid is centrifuged. 31А06482 purulent meningitis is determined in the supernatant, and with alkaline phosphatase activity and with activity of 2.5 U / l and below, serous meningity of 3.5 U / l is activated and the diagnosis is increased.