Klockars M, Reitamo S, Weber T, Kerttula Y
Acta Med Scand. 1978;203(1-2):71-4. doi: 10.1111/j.0954-6820.1978.tb14834.x.
The concentration of lysozyme (LZM) in cerebrospinal fluid was determined in 25 patients with bacterial meningitis, in 18 patients with viral meningitis and in 25 control patients who had other fibrile illnesses. The concentration of LZM was less than 1.5 microgram/ml in all control patients, and slightly to markedly raised in 10 patients with viral meningitis and in 11 out of 13 patients with untreated bacterial meningitis. The concentration of LZM was significantly different in the viral and bacterial meningitis patients (p less than 0.001). Most raised concentrations of cerebrospinal fluid LZM persisted for at least one week after the start of antibiotic treatment. The concentrations of LZM correlated well with concentrations of lactic dehydrogenase. These results show that the determination of cerebrospinal fluid LZM is a useful tool in the differential diagnosis of meningitis, particularly when the prehospital treatment with antibiotics may be responsible for a diagnostically misleading negative bacterial culture of the cerebrospinal fluid and altered cerebrospinal fluid cytology.
对25例细菌性脑膜炎患者、18例病毒性脑膜炎患者以及25例患有其他发热性疾病的对照患者的脑脊液中溶菌酶（LZM）浓度进行了测定。所有对照患者的LZM浓度均低于1.5微克/毫升，10例病毒性脑膜炎患者以及13例未经治疗的细菌性脑膜炎患者中的11例，其LZM浓度有轻度至显著升高。病毒性脑膜炎患者和细菌性脑膜炎患者的LZM浓度存在显著差异（p<0.001）。脑脊液LZM的大多数升高浓度在抗生素治疗开始后至少持续一周。LZM浓度与乳酸脱氢酶浓度密切相关。这些结果表明，脑脊液LZM的测定是脑膜炎鉴别诊断中的一项有用工具，尤其是在院前使用抗生素治疗可能导致脑脊液细菌培养呈诊断性误导阴性以及脑脊液细胞学改变的情况下。
