布鲁氏菌性脑膜炎的精准化诊断与治疗研究进展

doi:10.19982/j.issn.1000-6621.20260402

摘要/Abstract

摘要：

布鲁氏菌性脑膜炎(Brucella meningitis, BM)为神经型布鲁氏菌病(neurobrucellosis, NB)最常见分型,该病起病隐匿,与结核性脑膜炎鉴别难度大,易出现诊疗延误,遗留听力、认知损伤等高致残后遗症。笔者系统检索近5年国内外相关文献,归纳梳理BM阶梯分层诊断体系、多组学鉴别手段及分层个体化抗菌治疗方案,总结糖皮质激素适用规范、复发挽救策略,旨在优化临床鉴别流程、规范全程抗感染管理。建议后续开展多中心对照研究,搭建BM与结核性脑膜炎融合诊断模型,探索适配轻症、儿童、孕妇人群的降阶梯治疗方案。

关键词: 布鲁杆菌病, 脑膜炎, 诊断, 治疗学

Abstract:

Brucellar meningitis (BM) is the most common subtype of neurobrucellosis (NB). This disease features an insidious onset, creates formidable obstacles to its differentiation from tuberculous meningitis, and frequently results in delayed diagnosis and management, which may leave disabling sequelae such as hearing impairment and cognitive dysfunction. The authors systematically retrieved domestic and international literature published over the past five years, synthesized a stepwise stratified diagnostic system for BM, summarized multi-omics differential diagnostic tools and stratified individualized antibacterial regimens, and standardized the criteria for glucocorticoid application as well as salvage strategies for recurrent infections. This review intends to refine clinical differential diagnostic procedures and standardize full-cycle anti-infective administration. Further multicenter controlled studies are recommended to develop an integrated diagnostic model for BM and tuberculous meningitis, and to investigate de-escalation antibacterial protocols customized for mild cases, children and pregnant patients.

Key words: Brucellosis, Meningitis, Diagnosis, Therapeutics

中图分类号:

R515.2

穆斯塔帕·阿不力孜, 买尔旦·阿不来, 杨丽. 布鲁氏菌性脑膜炎的精准化诊断与治疗研究进展[J]. 中国防痨杂志, 2026, 48(9): 1422-1427. doi: 10.19982/j.issn.1000-6621.20260402

Musitapa Abulizi, Maierdan Abulai, Yang Li. Research progress on the precision diagnosis and treatment of Brucella meningitis[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1422-1427. doi: 10.19982/j.issn.1000-6621.20260402

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