结核性脑膜炎患者行脑脊液实验室检测方法的现状与进展

结核性脑膜炎(tuberculous meningitis,TBM)是最常见的肺外结核之一,约占全部结核病患者的1%;但死亡率可达26.8%,死亡多发生在患病最初的6个月,早期诊断及治疗是改善TBM预后的重要因素。临床上对TBM的诊断是通过临床表现、脑脊液检测、头颅影像学检查及是否并发颅外结核等综合分析后作出的。脑脊液检测是诊断TBM的重要指标,通过检测脑脊液中的结核分枝杆菌及其特异性的标志物,可以为TBM的诊断提供重要帮助。

Current situation and progress of cerebrospinal fluid-based laboratory tests in patients with tuberculous meningitis

Tuberculous meningitis (TBM) is one of the most common extra-pulmonary tuberculosis (TB), accounting for about 1% among all types of TB cases. The death rate of TBM can reach 26.8%, while the death usually occurs in the first six months. Early diagnosis and treatment are the important factors to improve the prognosis of TBM. Clinically, the diagnosis of TBM is made based on a comprehensive analysis by evaluating the clinical features, cerebrospinal fluid (CSF) tests, cerebral imaging features and the evidences of extra-cranial TB. The results of CSF-based tests are the important diagnostic indicators for TBM diagnosis. Detection of Mycobacterium tuberculosis and its specific markers in cerebrospinal fluid is extremely helpful for TBM diagnosis.