Abstract: Objective To explore the value of early secretory antigenic target-6 (ESAT-6) and interferon-γ (IFN-γ) in cerebrospinal fluid (CSF) for the diagnosis of tuberculous meningitis (TBM). Methods Eighty-one patients were examined in our hospital or outpatient clinic. Referenced to the diagnostic criteria of TBM, patients were divided into 3 groups: 21 cases were patients with TBM; 28 were patients with intracranial infection of non-TBM; and 32 controls without nervous system disease. CSF sample was collected by standard lumbar puncture and was used for detection of ESAT-6 and IFN-γ with enzyme-linked immunosorbent assay (ELISA). Results The concentration of ESAT-6 in the CSF of TBM group was 4.46 pg/ml [(2.20-10.55) pg/ml] and the IFN-γ was 34.86 ng/L [(25.62-241.71) ng/L]. The average concentrations of ESAT-6 and IFN-γ in the intracranial infection of non-TBM group and the control group were (1.18 ± 0.49) pg/ml, (12.00 ± 3.37) ng/L and (1.05 ± 0.47) pg/ml, (14.58 ± 3.46) ng/L, respectively. The levels of ESAT-6 and IFN-γ were significantly higher in the TBM group than in the intracranial infection of non-TBM group (H = 35.695, P = 0.000) and the control group (H = 31.560, P = 0.000), but were not significantly different between the intracranial infection of non-TBM group and the control group (t ＝1.226, P = 0.226; t = 0.060, P = 0.952, respectively). The Spearman rank correlation analysis showed positive correlation between ESAT-6 and IFN-γ detected in the TBM group (rs = 1.000, P = 0.000). Conclusion The levels of ESAT-6 and IFN-γ in the TBM group were significantly different from the intracranial infection of non-TBM group and the control group. The 2 indicators present certain correlation and can be helpful in the clinical diagnosis of TBM.

Key words: Tuberculosis, meningeal, Cerebrospinal fluid, Interferon typeⅡ, Enzyme-linked immunosorbent assay

摘要： 目的 探讨脑脊液早期分泌抗原靶-6（ESAT-6）和干扰素-γ表达水平变化对结核性脑膜炎的临床诊断价值。方法 采用酶联免疫吸附试验分别检测结核性脑膜炎（21 例）、非结核性脑膜炎颅内感染（28 例）和正常对照者（32 例）脑脊液ESAT-6 和干扰素-γ表达水平。结果 结核性脑膜炎组患者脑脊液ESAT-6 和干扰素-γ平均表达水平分别为4.46 pg/ml［（2.20 ~ 10.55）pg/ml］和34.86 ng/L［（25.62 ~241.71）ng/L］，均明显高于非结核性脑膜炎颅内感染组［（1.18 ± 0.49）pg/ml、（12.00 ± 3.37）ng/L］和正常对照组［（1.05 ± 0.47）pg/ml、（14.58 ± 3.46）ng/L］，差异具有统计学意义（H = 35.695，P = 0.000；H =31.560，P = 0.000）。非结核性脑膜炎颅内感染组与正常对照组之间差异无统计学意义（t = 1.226，P =0.226；t = 0.060，P = 0.952）。Spearman 秩相关分析显示，结核性脑膜炎组患者ESAT-6 水平与干扰素-γ水平呈正相关（rs = 1.000，P = 0.000）。结论 结核性脑膜炎患者脑脊液ESAT-6 和干扰素-γ表达水平明显高于非结核性脑膜炎颅内感染和正常对照者，检测这两项实验室指标的变化可协助结核脑膜炎的诊断，且两项指标之间具有一定相关性。

关键词: 结核, 脑膜, 脑脊髓液, 干扰素Ⅱ型, 酶联免疫吸附测定