Diagnostics of basal liqourrhea using identification of specific marker for cerebrospinal fluid - p-trace protein

Objective: to estimate the possibility of liquorrhea diagnostics by identification of β-trace protein (ß-ТР) concentrations in nasal discharges. Material and methods: The study was conducted in 3 stages. First stage included examination of β-ТР concentration in blood, CSF and nasal discharges at patients underwent transnasal operations or suffered from head injury or from idiopathic nasorrhea. Second stage included the identification of β-ТР in CSF at 8 patients with purulent meningitis and at 7 patients with subarachnoid hemorrhages (SAH) as well as blood concentration of β-ТР at 7 patients with acute renal failure (ARF). Third stage included the estimation of β-ТР concentration in nasal discharges at 17 patients suspected on basal liquorrhea. The identification of β-TP was conducted using automatic nephelometer BN ProSpec by nephelometric test with reagent N Latex betaTP. Results: We determined that blood concentration of β-TP was 0,5±0,1 mg/l (from 0,4 till 0,7 mg/l), CSF concentration of β-TP - 17,2±8,2 mg/l (from 9,7 till 37,7 mg/l) analyzing samples of blood, CSF and nasal discharged at 13 patients. The CSF concentration of β-TP unchanged at patients with SAH and was 16,2±7,0 mg/l, but this CSF concentration of β-TP decreased in 2,2 times at average (mean - 7,9±4,2 mg/l, min - 4,3 mg/l, max - 15,1 mg/l) at patients with meningitis. Blood concentration of β-TP increased slightly (up to 1,5±0,9 mg/l at average) at patients with ARF. The nephelometric test allowed identifying CSF in nasal discharges in 8 (36,4%) from 22 samples during examination of patients with suspect for basal liquorrhea that influence on treatment strategy. Laboratory method was ineffective for microliquorrhea diagnostics. Conclusion: nephelometric test for β-TP identification is effective for diagnostics of basal macroliquorrhea however purulent meningitis and acute renal failure must be taking into account during reading the results of analyzes.

ликворея, менингит, черепно-мозговая травма, САК, β-trace protein, liquorrhea

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