Chinese Journal of Antituberculosis ›› 2023, Vol. 45 ›› Issue (1): 18-24.doi: 10.19982/j.issn.1000-6621.20220425
• Interpretation of Standard • Previous Articles Next Articles
Received:
2022-10-31
Online:
2023-01-10
Published:
2022-12-30
Contact:
Shen Adong
E-mail:shenadong@bch.com.cn
CLC Number:
Wang Zeming, Shen Adong. Interpretation of Social Organization Standard of Diagnosis of central nervous system tuberculosis in children[J]. Chinese Journal of Antituberculosis, 2023, 45(1): 18-24. doi: 10.19982/j.issn.1000-6621.20220425
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诊断评分项目 | 评分(分) |
---|---|
接触史及临床表现 | 最高计6分 |
症状持续时间≥5d | 4 |
包含1种或多种结核中毒症状(如体质量减轻、盗汗等);或持续咳嗽≥2周 | 2 |
1年内与传染性结核病患者密切接触,或结核菌素皮肤试验/γ-干扰素释放试验阳性者(仅限于<10岁儿童) | 2 |
局灶性神经功能缺损(不包括脑神经麻痹) | 1 |
脑神经麻痹 | 1 |
意识状态改变 | 1 |
脑脊液检查 | 最高计4分 |
外观透明 | 1 |
细胞数为(10~500)×106/L | 1 |
淋巴细胞占比>50% | 1 |
蛋白质>1g/L | 1 |
葡萄糖<2.2mmol/L或低于血糖的50% | 1 |
头颅影像学检查 | 最高计6分 |
结核瘤 | 2 |
基底脑池的脑膜强化 | 2 |
平扫时颅底脑池变窄,密度增高 | 2 |
脑积水 | 1 |
脑梗死 | 1 |
其他部位结核病证据 | 最高计4分 |
胸部影像学提示活动性肺结核(肺结核2分,粟粒型肺结核4分) | 2/4 |
CT、MRI、超声检查提示存在颅外其他系统结核 | 2 |
脑脊液以外的标本(痰液、淋巴结、胃液、尿液、血液等)抗酸染色或MTB培养阳性 | 4 |
脑脊液以外的标本(痰液、淋巴结、胃液、尿液、血液等)MTB分子生物学检测阳性 | 4 |
排除诊断 通过病原学(涂片抗酸染色、培养或分子生物学检测)、免疫学或病理学检查,除外其他疾病,如化脓性脑膜炎、病毒性脑膜脑炎、隐球菌性脑膜炎、梅毒性脑膜炎、脑型疟疾、寄生虫性脑膜炎、嗜酸性粒细胞增多性脑膜炎、弓形体脑病、颅内占位性病变(如脑脓肿、恶性肿瘤等) |
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