Objective To analyze the correlation between changes in spinal fluid and serum neuron specific enolization enzyme( NSE), creatine kinase isoenzymes( CK-BB),lactic hydrogenase( LDH)isoenzymes in pediatric patients with viral encephalitis,and to evaluate the a-bove indicators in condition monitoring and prognosis evaluation in pediatric patients with viral encephalitis. Methods Pediatric patients with mild viral encephalitis( mild group,30 cases),severe viral encephalitis( severe group,30 cases)and non-infectious migraine( control group,30 ca-ses)were selected for this study,their blood and cerebral spinal fuid samples were collected at acute period( within 24 h after admission,3 d after their onset),recovery period(7 d after treatment)and control group were collected for examination of NSE,CK-BB and LDH isozymes,and these indexes in these three groups were compared. Results The difference in cerebrospinal fluid and serum NSE,CK-BB and LDH isozymes in these 3 groups in acute phase was statistically significant( P ﹤0. 05),and the difference in cerebrospinal fluid and serum NSE,CK-BB,LDH isozymes in recovery period of severe group and mild group was statistically significant( P ﹤0. 05). The difference in cerebrospinal fluid and ser-um NSE,CK-BB,LDH isozymes in recovery periods of mild and severe groups compared with those of acute phase was statistically significant( P ﹤0. 01). There was positive correlation in CSF NSE,CK-BB and serum NSE,CK-BB between mild group and severe group( P ﹤0. 01). Conclusion The combined detection of NSE,CK-BB and LDH isozymes is helpful for the early diagnosis of pediatric patients with viral enceph-alitis. Changes in cerebrospinal fluid and serum level of NSE,CK-BB exist significant correlation,the examination of above serum indices in-stead of those in cerebrospinal fluid can alleviate the pain in lumbar puncture,hence these may easily be accepted by their parents.%目的：分析病毒性脑炎患儿脑脊液和血清中神经元特异性烯醇化酶（ NSE）、肌酸激酶同工酶（ CK-BB）、乳酸脱氢酶（ LDH）变化的相关性，并评价上述指标变化对病毒性脑炎患儿病情监测及预后评估的意义。方法选择轻度病毒性脑炎（轻症组）、重度病毒性脑炎（重症组）以及非感染性偏头痛（对照组）患儿各30例，采集轻症组、重症组患儿急性期（入院后24 h内、发病3 d内）、恢复期（治疗后7 d）以及对照组急性期静脉血和脑脊液，分别测定NSE、CK-BB、LDH，比较组患者上述指标的变化情况。结果急性期3组患儿从对照组到轻症组、重症组，脑脊液、血清NSE、CK-BB、LDH水平依次升高，差异有统计学意义（ P ﹤0.05）；恢复期重症组患儿的脑脊液、血清NSE、CK-BB、LDH较轻症组差异均有统计学意义（ P ﹤0.05）；轻症组、重症组恢复期的脑脊液、血清NSE、CK-BB、LDH与急性期比较差异均有统计学意义（ P ﹤0.01）；轻症组、重症组的脑脊液NSE、CK-BB与血清NSE、CK-BB均呈显著正相关（ P ﹤0.01）。结论联合检测NSE、CK-BB、LDH有利于病毒性脑炎患儿的早期诊断；脑脊液、血清NSE、CK-BB水平变化存在显著相关性，上述指标检测建议采用血清检测代替脑脊液检测，能够减轻腰椎穿刺痛苦，易于被患儿家长接受。
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