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早期诊断结核性脑膜炎(下称结核脑)是一个难题。该病初发隐袭,症状无特征性,患者多未迅速就医。即使就医,在患者脑膜刺激征出现前,医生可能也无法明确诊断。对临床疑诊为结核脑的病例,常需进行腰椎穿刺试验。然而一般的脑脊液检查通常还不能下结论,因为早期标本直接涂片能找到结核杆菌者还不到10％。大多数这种病例,脑脊液是淋巴细胞性的,伴有高蛋白和低糖浓度,这些改变也在非结核脑病例中见到。脑脊液的其他诊断试验,如溴化物分配试验和腺甙脱氨酶活性测定,也未令人满意。通过酶联免疫吸附试验(ELISA)鉴定脑脊液中分支杆菌抗原的方法,虽然有研究价值,但作为常规临床应用又太复杂。
Early diagnosis of tuberculous meningitis (hereinafter referred to as tuberculosis) is a problem. Epidemic onset of the disease insomnia, no symptoms of symptoms, the patient has not been promptly medical treatment. Even if you seek medical attention, your doctor may not be able to confirm the diagnosis until the patient’s meningeal irritation appears. Suspected clinical TB cases of the brain, often need to carry out lumbar puncture test. However, the general cerebrospinal fluid examination is usually not conclusive, because early specimens can be found in direct smear Mycobacterium tuberculosis less than 10%. In most of these cases, cerebrospinal fluid is lymphatic, with high protein and sugar concentrations, and these changes are also seen in non-tuberculous brain cases. Other diagnostic tests of cerebrospinal fluid, such as the bromide distribution assay and the determination of adenosine deaminase activity, were also unsatisfactory. The identification of mycobacterial antigens in cerebrospinal fluid by enzyme-linked immunosorbent assay (ELISA), although of potential value, is too complex as a routine clinical application.