French G L, Teoh R, Chan C Y, Humphries M J, Cheung S W, O'Mahony G
Lancet. 1987 Jul 18;2(8551):117-9. doi: 10.1016/s0140-6736(87)92328-2.
Tuberculostearic acid, a structural component of Mycobacterium tuberculosis, was identified by gas chromatography/mass spectrometry with selected ion monitoring in cerebrospinal fluid (CSF) from 13 patients with proven and 8 out of 9 patients with suspected tuberculous meningitis; the negative result was in a patient whose symptoms and CSF abnormalities may have been due to systemic lupus erythematosus. Tuberculostearic acid was found in the CSF of only 1 patient out of 87 with non-tuberculous meningitis or non-infectious disorders; the single false-positive result was probably caused by intrathecal treatment with amikacin. Other aminoglycosides and antituberculous drugs did not interfere with the assay. In serial CSF samples from patients with tuberculous meningitis tuberculostearic acid was still present after 8 months of continuous supervised chemotherapy. Detection of tuberculostearic acid in CSF is a rapid, sensitive, and specific test for tuberculous meningitis, and can be used for retrospective diagnosis in patients who have been started on therapy.
结核硬脂酸是结核分枝杆菌的一种结构成分，通过气相色谱/质谱联用技术及选择离子监测，在13例确诊为结核性脑膜炎的患者和9例疑似结核性脑膜炎患者中的8例脑脊液中被检测到；1例症状和脑脊液异常可能由系统性红斑狼疮所致的患者检测结果为阴性。在87例非结核性脑膜炎或非感染性疾病患者中，仅1例在脑脊液中发现结核硬脂酸；这一单一假阳性结果可能是由阿米卡星鞘内注射治疗引起的。其他氨基糖苷类药物和抗结核药物不干扰该检测。在接受持续督导化疗8个月后的结核性脑膜炎患者的系列脑脊液样本中，仍可检测到结核硬脂酸。脑脊液中结核硬脂酸的检测是一种用于结核性脑膜炎的快速、灵敏且特异的检测方法，可用于已开始治疗患者的回顾性诊断。
