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[犬脑脊液葡萄糖水平降低的评估]

[Evaluation of decreased glucose levels in the cerebrospinal fluid of dogs].

作者信息

Weber J, Maiolini A, Tipold A

机构信息

Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Bünteweg 9, Hannover.

出版信息

Tierarztl Prax Ausg K Kleintiere Heimtiere. 2012 Oct 17;40(5):325-32.

Abstract

OBJECTIVE

The aim of the study was to evaluate the glucose ratio (glucose level in the cerebrospinal fluid [CSF]/blood glucose level) as a quickly available marker for detecting bacterial meningoencephalomyelitis (BM).

MATERIAL AND METHODS

Blood and CSF samples of 328 dogs were reviewed and evaluated retrospectively. Following the neurological diagnosis, the dogs were assigned to seven different groups: steroid-responsive meningitis-arteritis (SRMA), intervertebral disc disease (IVDD), neoplasia of the central nervous system (N), idiopathic epilepsy (IE), bacterial meningoencephalomyelitis (BM), meningoencephalomyelitis of other origin (ME) and healthy dogs.

RESULTS

The median of the CSF-glucose level (mmol/l) and the median of the glucose ratio in the SRMA group displayed the lowest values and differed significantly from the CSF-glucose levels of dogs in the groups IVDD, N, IE and healthy dogs (CSF-glucose level: p<0.01; glucose ratio: p<0.05). In the BM group, both parameters did not differ significant- ly from other groups, but displayed similar low levels as in the SRMA group. There was a negative correlation between the CSF cell count and the CSF-glucose ratio (Spearman correlation coefficient -0.322, p=0.01, R²=0.108).

CONCLUSION

The CSF-glucose concentration cannot be used as a distinct marker to differentiate BM from other inflammatory CNS-diseases, especially from SRMA usually accompanied by severe pleocytosis. Low CSF-glucose levels appear to be caused by elevated CSF cell counts rather than by bacterial metabolism.

CLINICAL RELEVANCE

For a definitive diagnosis of bacterial meningoencephalomyelitis in dogs, the detection of microorganisms remains necessary.

摘要

目的

本研究旨在评估葡萄糖比率(脑脊液[CSF]中的葡萄糖水平/血糖水平)作为检测细菌性脑膜脑脊髓炎(BM)的快速可用标志物。

材料与方法

回顾性分析328只犬的血液和脑脊液样本。在进行神经学诊断后,将犬分为七个不同的组:类固醇反应性脑膜炎-动脉炎(SRMA)、椎间盘疾病(IVDD)、中枢神经系统肿瘤(N)、特发性癫痫(IE)、细菌性脑膜脑脊髓炎(BM)、其他原因引起的脑膜脑脊髓炎(ME)和健康犬。

结果

SRMA组的脑脊液葡萄糖水平(mmol/l)中位数和葡萄糖比率中位数显示为最低值,与IVDD组、N组、IE组和健康犬组的脑脊液葡萄糖水平有显著差异(脑脊液葡萄糖水平:p<0.01;葡萄糖比率:p<0.05)。在BM组中,这两个参数与其他组无显著差异,但与SRMA组一样呈现相似的低水平。脑脊液细胞计数与脑脊液葡萄糖比率之间存在负相关(Spearman相关系数-0.322,p=0.01,R²=0.108)。

结论

脑脊液葡萄糖浓度不能作为区分BM与其他炎症性中枢神经系统疾病的明确标志物,尤其是与通常伴有严重细胞增多的SRMA区分开来。脑脊液葡萄糖水平低似乎是由脑脊液细胞计数升高引起的,而非细菌代谢。

临床意义

对于犬细菌性脑膜脑脊髓炎的明确诊断,检测微生物仍然是必要的。

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