Diagnosis Of Tuberculous Meningitis New Methods: Detection Concentration In Cerebrospinal Lfuid CFP-10and ESAT-6

Object:Using dialytic law concentrat the cerebrospinal fluid(CSF), increase theconcentration of the antigen in the CSF of tuberculous meningitis(TBM)，in order toincrease the sensitivity of the ELISA.,and to analyse its value in diagnosing TBM.Methods:1. CSF samples were collected from102inpatients during December2010toNovember2011,46of which were from clinically diagnosed TBM patients,56ofwhich were from other infections diseases of central nervous system (CNS) cases.2. Using dialysis bag to enrich cerebrospinal fluid.3. Using ELISA to detect the culture filtrate protein10(CFP-10) and earlysecreted antigenic target-6(ESAT-6) in CSF concentrate and CSF stoste, thespecificity and sensitivity of this method were assessed according to the statisticalanalysis,assess its diagnosing value of the clinical diagnose of TBM.Results:1.By ELISA determination, the CSF stoste of the TBM group CFP-10andESAT-6were consistent, are13.04%(06/46), did not appear false-positive, thesensitivity is13.04%; the CSF stoste of the non-TBM group CFP-10and ESAT-6alldid not appear false-positive (0/56), specificity is100.00%.2.By ELISA determination, The concentration cerebrospinal fluid positivity forESAT-6in cases of clinically diagnosed TBM was78.26%(36/46), false-negative was21.74%，sensitivity for CFP-10was78.26%；specificity of non-TBM patients was96.42%.3.By ELISA determination, the concentration cerebrospinal fluid positivity forESAT-6in cases of clinically diagnosed TBM was76.09%(35/46), false-negative was23.91%，sensitivity for CFP-10was76.09%；specificity of non-TBM patients was98.18%.4. By χ2test, there was a significant difference in clinically TBM patients between the CSF stoste and the concentration cerebrospinal fluid(P<0.01);there was astatistically insignificant in non-TBM patients between the CSF stoste and theconcentration cerebrospinal fluid(P>0.05); there was a significant difference betweenthe clinically TBM patients and the non-TBM patients (P<0.01).Conclusions：Using the dialysis to concentrate samples can increase the specificity andsensitivity of the CFP10and ESAT-6detected by specific antigen ELISA, it is asimple, quick and effective method to diagnose TBM. This is also an importantmethod for patients with TBM in the early stage, combined the examination of CSFand patient’s Clinical manifestation, the early diagnosis and treatment of TBM caneasily be made.