Donald P R, Malan C
S Afr Med J. 1985 Jan 5;67(1):19-20.
The value of cerebrospinal fluid (CSF) lactate and lactate dehydrogenase (LD) values as aids in differentiating tuberculous meningitis (TBM) from aseptic meningitis has been investigated. Using an upper limit of normal for CSF lactate levels of 2,75 mmol/l resulted in detection of 24 out of 26 cases of TBM (a sensitivity of 92%). If, however, a level of 3,85 mmol/l was taken as the upper limit of normal, then 18 out of 26 cases were detected (a sensitivity of 69%). Using 40 U/l as the upper limit of normal for LD levels detected 21 out of 38 cases of TBM (a sensitivity of 55%). Both tests may give normal values in the presence of TBM, but this should not cause specific antituberculosis therapy to be withheld. Neither test appears to hold marked advantages over conventional chemical analysis of CSF in differentiating TBM from aseptic meningitis.
脑脊液（CSF）乳酸和乳酸脱氢酶（LD）值在鉴别结核性脑膜炎（TBM）与无菌性脑膜炎中的作用已得到研究。将脑脊液乳酸水平正常上限设定为2.75 mmol/L时，26例TBM病例中有24例被检测出（敏感性为92%）。然而，如果将3.85 mmol/L作为正常上限，则26例病例中有18例被检测出（敏感性为69%）。将LD水平正常上限设定为40 U/L时，38例TBM病例中有21例被检测出（敏感性为55%）。在TBM存在的情况下，这两项检测都可能给出正常数值，但这不应该导致停止进行特异性抗结核治疗。在鉴别TBM与无菌性脑膜炎方面，这两项检测似乎都没有比脑脊液常规化学分析具有明显优势。
