不同检测方法在结核性脑膜炎诊断中的应用价值.docVIP

不同检测方法在结核性脑膜炎诊断中的应用价值 　　[摘要] 目的 探?外周血T细胞斑点试验（T-SPOT.TB）、脑脊液结核分枝杆菌培养及结核菌素试验（PPD试验）在结核性脑膜炎诊断中的应用价值。 方法 选择2015年1月～2016年12月延安大学附属医院收治的疑似结核性脑膜炎患者65例为研究对象，所有患者均行外周血T-SPOT.TB、脑脊液结核分枝杆菌培养及PPD试验。观察比较3种检测方法的在结核性脑膜炎诊断中的灵敏度、特异度等。 结果 65例患者中，35例为结核性脑膜炎患者，30例为非结核性脑膜炎患者。结核性脑膜炎患者中，T-SPOT.TB阳性率为74.29%，明显高于结核分枝杆菌培养及PPD试验的阳性率（40.00%，57.14%），且PPD试验阳性率高于结核分枝杆菌培养，差异有统计学意义（P 　　[关键词] 结核性脑膜炎；外周血；T细胞斑点试验； 结核分枝杆菌培养；结核菌素试验；诊断 　　[中图分类号] R529.3 [文献标识码] A [文章编号] 1673-7210（2017）06（a）-0119-04 　　Application value of different testing methods in the diagnosis of tuberculous meningitis 　　WANG Juanjuan MA Li▲ 　　Department of Neurology， Yan an University Affiliated Hospital， Shaanxi Province， Yanan 716000， China 　　[Abstract] Objective To explore the application value of peripheral blood T-SPOT.TB， cerebrospinal fluid mycobacterium tuberculosis culture and tuberculin test （PPD test） in the diagnosis of tuberculous meningitis. Methods 65 cases of patients suspected tuberculous meningitis from January 2015 to December 2016 in Yan an University Affiliated Hospital were chosen as the research objects. All patients were given the test of peripheral blood T-SPOT.TB， cerebrospinal fluid mycobacterium tuberculosis culture and PPD test. The sensitivity， specificity in the diagnosis of tuberculous meningitis were compared among the three testing methods. Results Among 65 patients， there were 35 cases with tuberculous meningitis and 30 cases with non-tuberculous meningitis. In patients with tuberculous meningitis， the positive rate of T-SPOT.TB test was 74.29%， and it was significantly higher than that of mycobacterium tuberculosis cultivate and PPD test （40.00%， 57.14%）， and the positive rate of the PPD test was higher than that of mycobacterium tuberculosis culture， with statistically significant differences （P 　　[Key words] Tuberculous meningitis； Peripheral blood； T cells spot test； Mycobacterium tuberculosis culture； Tuberculin test； Diagnosis 　　结核性脑膜炎是由结核分枝杆菌引起脑膜、脊膜的非化脓性炎症性疾病，是临床上最为常见、严重的肺外结核，具有较高的致