CSF分析

定义

Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surrounds and protects the brain and spinal cord. The tests may look for proteins, sugar (glucose), and other substances.

选择的名字

Cerebrospinal fluid analysis

How the Test is Performed

A sample of CSF is needed. A 腰椎穿刺, also called a spinal tap, is the most common way to collect this sample. Less common ways to take a fluid sample include:

• 池状的穿刺
• Removal of CSF from a tube that is already in the CSF, 比如分流器, 心室排水, 或者镇痛泵
• 心室穿刺

After the sample is taken, it is sent to the laboratory for evaluation.

Your health care provider will ask you to lie flat for at least one hour after the 腰椎穿刺. You may develop a headache after the 腰椎穿刺. If it happens, fluids and drinking caffeinated beverages such as coffee, tea or soda may help.

How to Prepare for the Test

Your provider will tell you how to prepare for 腰椎穿刺. Make sure to let them know all of the medicines you are taking in case any adjustment is needed.

Why the Test is Performed

Analysis of CSF can help detect certain conditions and diseases. All of the following can be, but are not always, measured in a sample of CSF:

• Antibodies and DNA of common viruses
• Bacteria (including that which causes syphilis, using a 性病研究化验室试验)
• 细胞计数
• 氯
• 隐球菌 抗原
• 葡萄糖
• 谷氨酰胺
• 乳酸脱氢酶
• 寡克隆条带 to look for specific proteins
• 髓鞘碱性蛋白
• 血清总蛋白
• Whether there are cancerous cells present (CSF cytology)
• 开启压力

正常的结果

正常结果包括:

• Antibodies and DNA of common viruses: None
• Bacteria: No bacteria grows in a lab culture
• 癌症ous cells: No cancerous cells present
• 细胞计数: 0 to 5 white blood cells (all mononuclear) and 0 red blood cells
• 氯: 110 to 125 mEq/L (110 to 125 mmol/L)
• 真菌:没有
• Gamma globulin: 3% to 12% of the total protein
• 葡萄糖: 50 to 80 mg/dL or 2.77 to 4.44 mmol/L (or greater than two-thirds of blood sugar level)
• 谷氨酰胺: 6 to 15 mg/dL (410.5 ~ 1026微mol/L)
• 乳酸脱氢酶: less than 40 U/L
• Oligoclonal bands: 0 or 1 bands that are not present in a matched serum sample
• 蛋白质: 15 ~ 60mg /dL (0.15 to 0.6 g/L)
• 开启压力: 70 to 180 mm of water
• 髓鞘碱性蛋白: Less than 4ng/mL

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

An abnormal CSF分析 result may be due to many different causes, including:

• 癌症
• 脑炎 (such as Herpes simplex, West Nile, and Eastern Equine 脑炎 virus)
• 肝性脑病
• High blood sugar (hyperglycemia)
• 感染
• 炎症
• 瑞氏综合征
• 脑膜炎 due to bacteria, fungus, tuberculosis, or a virus
• 多发性硬化(MS)
• 阿尔茨海默病
• 可见cerebrii
• Normal pressure hydrocephalus

参考文献

Euerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7日艾德. Philadelphia, PA: Elsevier; 2019:chap 60.

罗森博格GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8日艾德. Philadelphia, PA: Elsevier; 2022: chap 88.

Schnapp BH, Jewell C. Central nervous system infections. In: Walls RM，编辑. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10日艾德. Philadelphia, PA: Elsevier; 2023:chap 95.