Zots Y. Diagnostic significance of stress-associated hormones in patients with acute bacterial meningitis

The thesis focuses on the improvement of diagnostic effectiveness and prognosis of acute bacterial meningitis based on the determination of basic stress-associated hormones, the activity of a non-specific enzyme and neuron-specific enolase in the cerebrospinal fluid and blood serum. Clinical and laboratory data obtained from 127 patients with acute bacterial meningitis were analyzed depending on the severity of disease, taking into account a premorbid condition, age and sex of patients. In 66 patients with acute bacterial meningitis of meningococcal and pneumococcal etiology, the content of stress-associated hormones (adrenocorticotropic hormone, cortisol, thyroid-stimulating hormone, triiodothyronine, and thyroxine), a marker of tissue hypoxia lactate, the activity of enzymes – lactate dehydrogenase, creatine kinase, cholinesterase and neuron-specific enolase in the cerebrospinal fluid and serum depending on etiology, severity and disease outcome was analyzed. An increase in neuron-specific enolase activity in the cerebrospinal fluid indicates the destruction of neurons and depends on the severity of acute bacterial meningitis, while its level in serum reflects the severity, etiology and disease outcome. The revealed imbalance of stress-associated hormones in both cerebrospinal fluid and serum is dependent on the severity and etiology of acute bacterial meningitis. Changes in lactate concentrations, as well as the lactate dehydrogenase and cholinesterase activity, in the cerebrospinal fluid of patients with acute bacterial meningitis, which reflect hypoxia of CNS tissues and metabolic disorders, contribute to the more severe course of the pathological process. The content of lactate and cholinesterase activity in the cerebrospinal fluid were elevated and depended on the disease severity, whereas the activity of cholinesterase and lactate dehydrogenase on the disease etiology. An association between an increase in adrenocorticotropic hormone and triiodothyronine in the cerebrospinal fluid of patients with acute bacterial meningitis of pneumococcal etiology, an increase in cortisol and neuron-specific enolase activity, a decrease in serum adrenocorticotropic hormone with a fatal outcome was found.