Clinical significance of cerebrospinal fluid biochemistry

The human brain is a very magical part. Similarly, precisely because it is so magical, contemporary science has not yet clearly studied what special functions and structures the brain has that are unknown to people. So there are still many things about the brain that are worthy of curiosity. Let us now understand the clinical significance of cerebrospinal fluid biochemistry.

1. Protein quantification: Increased in (1) Central nervous system infection: purulent meningitis significantly increased,

(1) Nuclear meningitis has a moderate increase, viral encephalitis may be normal or slightly increased, and new cryptococcal meningitis has a slight increase; (2) Radiculopathy: such as acute infectious polyradiculoneuritis, in most cases the cerebrospinal fluid protein increases, while the cells are normal or close to normal, showing protein-cell separation; (3) Intraspinal obstruction: seen in spinal cord tumors, metastatic cancer, etc.; (4) Others: such as brain tumors, brain abscesses, cerebral hemorrhage, etc.

Meningitis: purulent meningitis is significantly reduced, the lower the glucose content, the more severe the disease and the worse the prognosis;

(2) Brain parasitic diseases: such as cerebral cysticercosis, schistosomiasis, paragonimiasis, toxoplasmosis, etc.; (3) Brain

Tumors, especially malignant tumors; (4) neurosyphilis; (5) hypoglycemia, etc. Increased glucose is seen in

(1) Premature infants or newborns: mainly due to the high permeability of the blood-brain barrier; (2) Viral encephalitis

or meningitis; (3) acute trauma or poisoning affecting the brain stem; (4) cerebral hemorrhage; (5) diabetes, etc.

3. Chloride quantification : Chloride reduction is mainly seen in: (1) Bacterial or fungal infection of the brain: common in suppuration

Meningitis, tuberculous meningitis and fungal meningitis. Especially in tuberculous meningitis, the decrease of chloride in cerebrospinal fluid is particularly obvious, which occurs earlier than the decrease of glucose. Therefore, it has certain value in distinguishing tuberculous meningitis from purulent meningitis. Chloride levels are usually normal in viral meningitis, poliomyelitis, brain abscess, and neurosyphilis. (2) Hypochloremia: When blood chloride is reduced due to various reasons such as abnormal loss of chloride in the body, insufficient intake, etc., the chloride level in the cerebrospinal fluid may also decrease accordingly. Elevated chloride is mainly seen in uremia, nephritis, heart failure, etc.

4. Aspartate aminotransferase : Increased levels are seen in cerebral infarction, cerebral atrophy, toxic encephalopathy, and acute craniocerebral injury.

5. Alanine aminotransferase : Increased levels are seen in metastatic cancer to the nervous system.

6. Lactate dehydrogenase : Increased levels are seen in brain tissue necrosis, subarachnoid hemorrhage, cerebral hemorrhage, cerebral infarction,

Tumor, acute phase of demyelinating disease.