核酸扩增试验用于结核性脑膜炎诊断的进展

Nucleic acid amplification in diagnosis of tuberculous meningitis

造成结核性脑膜炎(TBM)病死率高的主要原因是该病临床特征与其他形式的亚急性脑脑炎相近,因而临床诊断困难。常规方法如抗酸杆菌涂片(AFB)和结核菌培养用于诊断敏感性低或者费时,分子诊断技术(主要是核酸扩增技术)用于TBM的诊断报道逐年增加,该技术除了快速诊断、同时检测耐药性的优势外,还有助于提高疗效,大大缩短TBM的治疗时间。本文系统性分析近年来国内外相关文献报道,探讨分子诊断技术应用于TBM诊断的价值,为临床应用提供有用的信息。

The main reason for the high mortality of tuberculous meningitis(TBM)is that the clinical features of the disease are similar to other forms of subacute encephalitis,so its clinical diagnosis is difficult.Conventional methods such as acid-fast bacilli smear(AFB)and tuberculosis culture for its diagnosis have low sensitivities,or are time-consuming.Reports of molecular diagnosis,mainly nucleic acid amplification,for TBM diagnosis are increasing year by year.In addition to rapid diagnosis and the advantages of detecting drug resistance at the same time,it helps to improve the efficacy and greatly shorten the treatment time of TBM.This review summarizes the relevant literature reports at home and abroad in recent years,discusses the value of molecular diagnostic technology for TBM,and provides useful information for clinical application.