Abstract:
Objective
To observe and analyze the cytological characteristics of cerebrospinal fluid (CSF) in children with tuberculous meningitis and viral meningitis.
Methods
Twenty cases of tuberculous meningitis and 20 cases of viral meningitis admitted to Children's Hospital of Hunan Province from December 2015 to December 2016 were selected as the TB group and virus group respectively. The cytological differences of cerebrospinal fluid between the two groups were observed. (1) The percentage of small lymphocytes, lymphoid cells, transformed lymphocytes, monocytes activated and neutrophils in cerebrospinal fluid was analyzed in the two groups. (2) Serum albumin(CALB), cerebrospinal albumin(SALB) and cerebrospinal albumin index(CALB index) were detected in the two groups of children. (3) Evaluate the severity of blood-brain barrier injury in the two groups.
Results
Compared with the children in the virus group, the children in the tuberculosis group had fewer lymphoid cells in the cerebrospinal fluid and more activated monocytes and neutrophils, and the difference was statistically significant(P<0.05). The number of plasma cells and monocytes in cerebrospinal fluid of the two groups was not statistically different(P>0.05). SALB and CALB index were significantly higher in the tuberculosis group than in the virus group, and the difference was statistically significant(P<0.05). There was no significant difference in CALB between the two groups(P>0.05). The severity of blood-brain barrier injury in the tuberculosis group was significantly higher than that in the virus group, and the difference was statistically significant(P<0.05). In addition, the small and medium lymphocytes, lymphoid cells, metastatic lymphocytes, and activated monocytes of cerebrospinal fluid were significantly increased in both groups after 8 weeks of treatment, and the neutrophilic granulocytes were significantly decreased, with statistically significant differences(P<0.05). There was no significant difference in the proportion of various cells in the two groups after treatment(P>0.05).
ConclusionCytological examination of cerebrospinal fluid can provide a reference for differential diagnosis of tuberculous meningitis and viral meningitis in children, which is of great value in clinical treatment.

Key words: Tuberculous meningitis, Viral meningitis, Cerebrospinal fluid, Cytology, Child