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结核性脑膜炎(TBM)是结核分枝杆菌侵犯脑膜引起的颅内非化脓性炎症,是常见且后果严重的肺外结核病,因其缺乏特异性的临床表现,且病原学的检出率低,临床常因早期诊断困难而延误诊治,造成严重的后遗症甚至死亡。因此早期诊断对于TBM的治疗及预后有极其重要的作用。近年来,国内外学者不断研究TBM的早期诊断方法 ,目前常用的方法仍主要是脑脊液的检测,包括脑脊液常规生化,细胞学检测等,近年来发展的改良抗酸染色及脑脊液的PCR检测提高了脑脊液中结核菌的检出率,对疾病的早期诊断起到了重要作用。另外,结核杆菌T细胞检测及γ干扰素诱导蛋白-10等新方法也为TBM的早期诊断提供了新的方法。本文就近年来国内外对TBM的早期诊断研究进行综述。
Tuberculous meningitis (TBM) is a noninflammatory intracranial inflammatory disease caused by Mycobacterium tuberculosis invaded by Mycobacterium tuberculosis and is a common and serious extra-pulmonary tuberculosis due to its lack of specific clinical manifestations and low detection rate of etiology , Clinical diagnosis is often delayed due to the difficulties of early diagnosis and treatment, causing serious sequelae or even death. Therefore, early diagnosis of TBM treatment and prognosis have an extremely important role. In recent years, scholars at home and abroad continue to study the early diagnosis of TBM, the commonly used method is still mainly the detection of cerebrospinal fluid, including cerebrospinal fluid routine biochemical, cytological testing, improved in recent years, improved acid-fast staining and PCR detection of cerebrospinal fluid improved The detection rate of TB in cerebrospinal fluid has played an important role in the early diagnosis of the disease. In addition, the detection of Mycobacterium tuberculosis T cells and γ interferon-inducible protein-10 and other new methods for the early diagnosis of TBM provides a new method. This article reviews the early diagnosis of TBM in recent years.