Radhakrishnan V V, Mathai A
Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Indian J Pathol Microbiol. 1993 Oct;36(4):341-7.
In the study Mycobacterium tuberculosis was isolated in the cerebrospinal fluid (CSF) specimens of patients with tuberculous meningitis (TBM) by the conventional bacteriological technique. The isolation rate of M. tuberculosis was found to be 11.5% in lumbar, 75% in ventricular and 87.5% in cisternal CSFs. Low isolation rate of M. tuberculosis in lumbar CSF is due the low density of tubercle bacilli in lumbar CSF than in cisternal CSF. However M. tuberculosis antigen 5 is present in significant concentration in CSFs. The antigen concentration in CSF was estimated by an inhibition enzyme-linked immunosorbent assay (ELISA). Since CSF specimens can not be collected from ventricular or cisternal routes for the routine bacteriological investigations in patients with TBM, estimation of M. tuberculosis antigen 5 concentration in lumbar CSF by an inhibition ELISA may be considered as an adjunct in the laboratory diagnosis of TBM. This is particularly relevant in those patients in whom bacteriological methods fail to demonstrate M. tuberculosis in CSF specimens.
在该研究中，采用传统细菌学技术从结核性脑膜炎（TBM）患者的脑脊液（CSF）标本中分离出结核分枝杆菌。结果发现，腰椎CSF中结核分枝杆菌的分离率为11.5%，脑室CSF中为75%，脑池CSF中为87.5%。腰椎CSF中结核分枝杆菌分离率低是由于腰椎CSF中结核杆菌的密度低于脑池CSF。然而，结核分枝杆菌抗原5在CSF中以显著浓度存在。通过抑制酶联免疫吸附测定（ELISA）来估计CSF中的抗原浓度。由于在TBM患者的常规细菌学检查中无法从脑室或脑池途径采集CSF标本，因此通过抑制ELISA估计腰椎CSF中结核分枝杆菌抗原5的浓度可被视为TBM实验室诊断的辅助手段。这在那些细菌学方法未能在CSF标本中检测出结核分枝杆菌的患者中尤为重要。
