结核性脑膜炎实验室诊断技术进展

中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (12): 822-824.

结核性脑膜炎实验室诊断技术进展

朱长太胡忠义

200433 同济大学附属上海市肺科医院/上海市结核病（肺）重点实验室

收稿日期:2011-06-28 出版日期:2011-12-10 发布日期:2012-02-15
通信作者: 胡忠义 E-mail:shtblab@163.com

The progress of laboratory diagnostic techniques of tuberculous meningitis

ZHU Chang-tai，HU Zhong-yi

Received:2011-06-28 Online:2011-12-10 Published:2012-02-15
Contact: HU Zhong-yi E-mail:shtblab@163.com

摘要/Abstract

摘要： 结核性脑膜炎是肺外结核较为常见的疾病，约占结核病的0.5%～1.0%。全世界结核性脑膜炎自20世纪60年代以后稳步下降，但20世纪80年代后开始呈上升趋势。尤其是近年来，耐药结核分枝杆菌广泛传播及艾滋病的流行和免疫制剂的广泛应用，使得结核性脑膜炎发病率亦随之增高。结核性脑膜炎是死亡率最高的肺外结核病，早期诊断对于提高患者的生存率尤其重要。但在临床工作中，早期结核性脑膜炎患者临床表现和脑脊液改变多不典型，易与细菌性脑膜炎、病毒性脑膜炎等相混淆。因此，采取有效的实验室技术方法对于结核性脑膜炎诊断与治疗有着重要意义。笔者就结核性脑膜炎实验室诊断技术的进展评述如下。

朱长太胡忠义. 结核性脑膜炎实验室诊断技术进展[J]. 中国防痨杂志, 2011, 33(12): 822-824.

ZHU Chang-tai，HU Zhong-yi. The progress of laboratory diagnostic techniques of tuberculous meningitis[J]. Chinese Journal of Antituberculosis, 2011, 33(12): 822-824.

参考文献

［1］Janvier F, Mérens A, Fabre M, et al. Tuberculous meningitis: diagnosis and therapeutic difficulties. Ann Biol Clin (Paris),2010,68(3):355-361.

［2］梁湘辉,宋婕,刘文恩.液基集菌制片技术检测抗酸杆菌的临床应用研究.中国防痨杂志,2009,31(2):86-89.

［3］Moore DA, Evans CA, Gilman RH, et al. Microscopicobservation drug-susceptibility assay for the diagnosis of TB. N Engl J Med,2006, 355(15):1539-1550.

［4］Caws M, Dang TM, Torok E, et al. Evaluation of the MODS culture technique for the diagnosis of tuberculous meningitis. PLoS One,2007,2(11):e1173.

［5］Piuri M, Jacobs WR Jr, Hatfull GF. Fluoromycobacteriopha-ges for rapid, specific, and sensitive antibiotic susceptibility testing of Mycobacterium tuberculosis. PLoS One, 2009,4(3):e4870.

［6］Minion J, Pai M. Bacteriophage assays for rifampicin resistance detection in Mycobacterium tuberculosis: updated meta-analysis. Int J Tuberc Lung Dis,2010, 14(8):941-951.

［7］冯云,邵凌云,孟成艳,等.酶联免疫斑点法诊断结核性脑膜炎临床研究.传染病信息,2009,22(5):301304.

［8］Kim SH, Cho OH, Park SJ, et al. Rapid diagnosis of tuberculous meningitis by T cell-based assays on peripheral blood and cerebrospinal fluid mononuclear cells. Clin Infect Dis,2010,50(10):1349-1358.

［9］Bera S, Shende N, Kumar S, et al. Detection of antigen and antibody in childhood tuberculous meningitis. Indian J Pediatr,2006,73(8):675-679.

［10］Sardella IG, Singh M, Kumpfer S, et al. Evaluation of Lionex TB kits and mycobacterial antigens for IgG and IgA detection in cerebrospinal fluid from tuberculosis meningitis patients. Mem Inst Oswaldo Cruz,2010,105(5):722-728.

［11］Mathai A, Radhakrishnan VV, Sarada C, et al. Detection of heat stable mycobacterial antigen in cerebrospinal fluid by Dot-Immunobinding assay. Neurol India,2003,51(1):52-54.

［12］Venkatesh K, Parija SC, Mahadevan S, et al. Reverse passive haemagglutination (RPHA) test for detection of mycobacterial antigen in the cerebrospinal fluid for diagnosis of tubercular meningitis. Indian J Tuberc,2007,54(1):41-48.

［13］Mudaliar AV, Kashyap RS, Purohit HJ, et al. Detection of 65 kD heat shock protein in cerebrospinal fluid of tuberculous meningitis patients. BMC Neurol，2006, 6:34.

［14］Rafi W, Venkataswamy MM, Ravi V, et al. Rapid diagnosis of tuberculous meningitis: a comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen. J Neurol Sci,2007,31,252(2):163-168.

［15］Sharma K, Sharma A, Singh M, et al. Evaluation of polyme-rase chain reaction using protein b primers for rapid diagnosis of tuberculous meningitis.Neurol India, 2010,58(5):727-731

［16］Kusum S, Aman S, Pallab R, et al. Multiplex PCR for rapid diagnosis of tuberculous meningitis. J Neurol,2011,258(10):1781-1787.

［17］Takahashi T, Nakayama T. Novel technique of quantitative nested real-time PCR assay for Mycobacterium tuberculosis DNA. J Clin Microbiol,2006,44(3):1029-1039.

［18］Aryan E, Makvandi M, Farajzadeh A, et al. A novel and more sensitive loop-mediated isothermal amplification assay targeting IS6110 for detection of Mycobacterium tuberculosis complex. Microbiol Res, 2010,165(3):211-220.

［19］Nagdev KJ, Kashyap RS, Parida MM, et al. Loop-mediated isothermal amplification for rapid and reliable diagnosis of tuberculous meningitis. J Clin Microbiol,2011,49(5):1861-1865.

［20］Vidal JE, de Oliveira AC, Hernández AV.CD4⁺ T cell count and cerebrospinal fluid findings in HIV-infected patients with tuberculous meningitis. Int J Tuberc Lung Dis,2010,14(11):1496-1497.

［21］Xu HB, Jiang RH, Li L, et al.Diagnostic value of adenosine deaminase in cerebrospinal fluid for tuberculous meningitis: a meta-analysis.Int J Tuberc Lung Dis,2010,14(11):1382-1387.

［22］Tuon FF, Higashino HR, Lopes MI, et al. Adenosine deaminase and tuberculous meningitis—a systematic review with meta-analysis. Scand J Infect Dis,2010, 42(3):198-207.

［23］Baran J Jr, Riederer KM, Khatib R. Limits of detection of Mycobacterium tuberculosis in spiked cerebrospinal fluid using the polymerase chain reaction in tuberculous meningitis. Eur J Clin Microbiol Infect Dis,2000,19(1):47-50.