结核性脑膜炎诊断方法研究进展

Research progress on diagnosis methods of tuberculous meningitis

结核性脑膜炎(tuberculous meningitis,TBM)是最常见的中枢神经系统结核病类型,也是最严重的肺外结核,常以非特异性症状起病。目前,所有的TBM诊断技术均不完美,虽患者脑脊液(cerebrospinal fluid,CSF)指标变化明显,但不具有特异性;加之CSF中的细菌载量非常低,相关实验室检测技术诊断敏感度低、耗时长。笔者通过总结目前TBM诊断中存在的问题,对TBM的不同诊断方法的最新研究进展和利弊进行综述,为进一步提高TBM患者确诊率,避免患者治疗时机的延误提供参考。

Tuberculous meningitis(TBM)is the most common tuberculosis of the central nervous system and the most severe extra-pulmonary tuberculosis,which often onset with nonspecific symptoms.At present,all TBM diagnostic techniques are not perfect.Although the cerebrospinal fluid(CSF)of patients changes obviously,it is still not specific.In addition,the bacterial load in CSF is very low,the diagnostic sensitivity of relevant laboratory testing techniques is low,and the duration is long.This artical summarized problems of the diagnosis of TBM,reviewed the recent research progress and advantages or disadvantages of different diagnostic methods for TBM,in order to improve the diagnosis rate of TBM and avoid delay of treatment.