Abstract
Objective To evaluate the value of early secretory antigenic target 6 (ESAT-6) in monocytes of cerebrospinal fluid (CSF) in the early diagnosis and judgment of the tuberculous meningitis (TBM). Methods Forty cases with TBM (TBM group) and 40 patients with other meningitis patients (control group,9 cases with purulent meningitis,24 cases with viral meningitis,3 cases with cryptococcal meningitis,3 cases with cerebral cysticercosis, 1 case with neurosyphyilis) were involved in this study.Conventional examination of CSF was inspected after admission, and the ESAT-6 in monocytes of CSF was detected by immunocytochemical stain. Results The positive rate of ESAT-6 was 24% in TBM group and 0 in control group (P < 0.01 ). In ROC curve, if the rate of ESAT-6 ≥8.5% judged as positive, and < 8.5% judged as negative, 35 patients of TBM group and 4 patients of control group were ESAT-6 positive. The sensitivity of the ESAT-6 in the diagnosis of TBM was 87.5%, and the specificity of TBM was 90.0%. Thirty patients in TBM group were not given anti-tuberculosis drug treatment, and the positive rate of ESAT-6 was 93.3% (28/30) before treatment, and was 46.7% (14/30) after treatment of 2 weeks (P =0.000).Conclusions ESAT-6 in monocytes of CSF detected by immunocytochemical stain has higher sensitivity and specificity in the diagnosis of TBM in early stage. Observing the positive rate of ESAT-6 dynamicly has practical value in judgment the severity of TBM. Key words: Tuberculosis,meningeal; Early diagnosis; Monocytes; Early secretory antigenic target 6; Cerebrospinal fluid
Published Version
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