不同检测方法在结核性脑膜炎诊断中的应用价值

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Abstract Objective To explore the application value of peripheral blood T-SPOT.TB, cerebrospinal fluid mycobacterium tuberculosis culture and tuberculin test (PPD test) in the diagnosis of tuberculous meningitis. Methods 65 cases of patients suspected tuberculous meningitis from January 2015 to December 2016 in Yan 'an University Affiliated Hospital were chosen as the research objects. All patients were given the test of peripheral blood T-SPOT.TB, cerebrospinal fluid mycobacterium tuberculosis culture and PPD test. The sensitivity, specificity in the diagnosis of tuberculous meningitis were compared among the three testing methods. Results Among 65 patients, there were 35 cases with tuberculous meningitis and 30 cases with non-tuberculous meningitis. In patients with tuberculous meningitis, the positive rate of T-SPOT.TB test was 74.29%, and it was significantly higher than that of mycobacterium tuberculosis cultivate and PPD test (40.00%, 57.14%), and the positive rate of the PPD test was higher than that of mycobacterium tuberculosis culture, with statistically significant differences (P < 0.05). In patients with non-tuberculous meningitis, the positive rate of PPD test was 26.27%, which was significantly higher than that of T-SPOT.TB and mycobacterium tuberculosis culture (10.00%, 0.00%), with statistically significant differences (P < 0.05). In the diagnosis of tuberculous meningitis, the sensitivity, specificity, positive predictive value, negative predictive value of T-SPOT.TB was 89.66%, 75.00%, 74.29%, 90.00% respectively, which were significantly higher than 71.43%, 59.46%, 57.14%, 73.33% of PPD test, with statistically significant differences (P < 0.05); the specificity and positive predictive value of T-SPOT. TB were higher than those of the mycobacterium tuberculosis culture (52.63%, 40.00%), with statistically significant differences (P < 0.05). Conclusion Peripheral blood T-SPOT.TB test in the diagnosis of tuberculous meningitis has high sensitivity and specificity, which is helpful for the rapidly diagnosing tuberculous meningitis. It is worthy of clinical promotion.

Key words： Tuberculous meningitis Peripheral blood T cells spot test Mycobacterium tuberculosis culture Tuberculin test Diagnosis

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	WANG Juanjuan MA Li▲

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WANG Juanjuan MA Li▲. Application value of different testing methods in the diagnosis of tuberculous meningitis[J]. 中国医药导报, 2017, 14(16): 119-122.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I16/119

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