Abstract: Objective To investigate the role of partial diagnostic indexes in TBM patients. Method TBM patients(group TBM, n=40), non-TBM patients(group NTBM, n=40, 20 viral meningitis patients and 20 cryptococcal meningitis patients) were enrolled in the study. The blood T-SPOT.TB, CSFADA and CSFTBAb were examined and the clinical data were collected. The data were analyzed by the software EmpowerStats 2.14.9, P<0.05 was considered to be statistical significant. Results The sensitivity, specifity, positive predictive values(PPV) and negative predictive values(NPV) of blood T-SPOT.TB, CSFADA and CSFTBAb were respectively 0.600, 0.950, 0.923, 0.704;0.500, 0.950, 0.909, 0.655 and 0.200, 0.975, 0.889, 0.549. The sensitivity of blood T-SPOT.TB and CSF ADA was higher than the CSFTBAb(P<0.001). The specifity, PPV and NPV of the blood T-SPOT.TB, CSFADA and CSFTBAb had no statistical difference(P>0.05). The positive rates of CSF mycobacterium tuberculosis PCR and cultivation(5.0%, 2/40; 2.5%, 1/40) showed no statistical significance(χ²=0.000, P=1.000). The cranial magnetic resonance showed meningeal enhancement occupied 62.5%(25/40), meningeal non-enhancement occupied 37.5% (15/40), hydrocephalus occupied 15.0%(6/40) and tuberculomas occupied 17.5%(7/40). Conclusions Blood T-SPOT.TB and CSFADA have higher diagnostic significance than CSFTBAb in the diagnosis of TBM. The cranial image is important in the diagnosis, therapy and prognosis of tuberculous meningitis.

Key words: Tuberculous meningitis, T-SPOT.TB, Cerebrospinal fluid, Diagnosis, Image