Ohtsuka C
Juntendo University Urayasu Hospital, Chiba.
No To Hattatsu. 1991 Mar;23(2):119-28.
The examination of cerebrospinal fluid has provided useful information for diagnosis of CNS infections. The progress of analytical technology has brought the possibility to detect very small amounts of chemical substances. I thought that new information from brain should be obtained by using modern analytical technology for several substances in CSF. Free amino acid pattern, glutamine, homocarnosine, glutamic acid decarboxylase (GAD), neuron specific enolase (NSE) and 2',5'-oligoadenylic acid synthetase (2-5 A) in CSF have been examined for information of brain injury and dysfunctions. The results are as follows. 1) The individual difference and constancy of free amino acid pattern in CSF were found in children without any neurological diseases. 2) The levels of free amino acids in CSF increased in the acute phase of bacterial meningitis. 3) High levels of glutamine in CSF of children with acute bacterial meningitis were normalized during the recovery phase. 4) A marked imbalance of free amino acids in CSF was found in children with Lennox-Gastaut syndrome. 5) A decrease of homocarnosine levels in CSF was related with the degree of unconsciousness in children suffering from neurological diseases. 6) High GAD activities in CSF were observed in the acute phase of aseptic meningitis and after intrathecal injection of methotrexate for the therapy against meningeal leukemia. 7) High NSE activities in CSF were found in the acute phase of bacterial meningitis, intracranial hemorrhage, encephalopathy and encephalitis. 8) High 2-5A activities CSF were measured in the acute phase of mumps meningitis with subsequent decreases during the recovery phase. These results suggest that several substances in CSF are useful as markers of brain injury and dysfunction.
脑脊液检查为中枢神经系统感染的诊断提供了有用信息。分析技术的进步使得检测极少量化学物质成为可能。我认为通过对脑脊液中的几种物质应用现代分析技术,应该能够从大脑中获取新信息。已经对脑脊液中的游离氨基酸模式、谷氨酰胺、高肌肽、谷氨酸脱羧酶(GAD)、神经元特异性烯醇化酶(NSE)和2',5'-寡腺苷酸合成酶(2-5A)进行了检测,以获取脑损伤和功能障碍的信息。结果如下:1)在无任何神经系统疾病的儿童中发现了脑脊液中游离氨基酸模式的个体差异和稳定性。2)细菌性脑膜炎急性期脑脊液中游离氨基酸水平升高。3)急性细菌性脑膜炎患儿脑脊液中高水平的谷氨酰胺在恢复期恢复正常。4)Lennox-Gastaut综合征患儿脑脊液中游离氨基酸明显失衡。5)患有神经系统疾病的儿童脑脊液中高肌肽水平降低与意识障碍程度相关。6)无菌性脑膜炎急性期及鞘内注射甲氨蝶呤治疗脑膜白血病后脑脊液中GAD活性升高。7)细菌性脑膜炎急性期、颅内出血、脑病和脑炎时脑脊液中NSE活性升高。8)腮腺炎脑膜炎急性期脑脊液中2-5A活性升高,恢复期随后降低。这些结果表明,脑脊液中的几种物质可作为脑损伤和功能障碍的标志物。