Abstract: ［Abstract］ Objective〖HTSS〗〓To analyze the clinical characteristics of tuberculous meningitis associated with tuberculosis and the advantages and disadvantages of improved acidfast staining of cerebrospinal fluid(CSF), tuberculosis bacterium antibody(TBAb), tuberculin skin test(TST) and interferongamma release assays(IGRAs) in the diagnosis of tuberculous meningitis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtysix cases of tuberculous meningitis were collected as tuberculous meningitis group(group A), 60 cases of other central nervous system diseases without tuberculosis as nontuberculous meningitis group(group B). Twentyeight cases of tuberculous meningitis with miliary tuberculosis were divided into tuberculous meningitis with miliary tuberculosis group(group C) and 38 cases without miliary pulmonary conjunctiva into tuberculosis group(group D). The sensitivity, specificity, positive predictive value and negative predictive value of CSF improved acidfast staining, TBAb, TST and IGRAs in group A and group B were calculated, and the positive rates of CSF improved acidfast staining, TBAb, TST and IGRAs in group C and group D were compared. The clinical effects of group C and group D were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive rate of modified acidfast staining, tuberculosis antibody detection, TST strong positive rate and IGRAs positive rate of CSF in group A were higher than those in group B(P＜005). There was no significant difference in the positive rate of CSF improved acidfast staining, tuberculosis antibody and TST between group C and group D(P＞005). The positive rate of IGRAs in group C was significantly higher than that in group D(P＜005). The sensitivity was IGRAs>TBAb>CSF improved acidfast staining>TST. Specificity was CSF improved acidfast staining>TST>IGRAs>TBAb. Positive predictive value was CSF improved acidfast staining>IGRAs>TST>TBAb. Negative predictive value was IGRAs>TBAb>CSF improved acidfast staining >TST. There was no significant difference in the improvement rate between group C and group D(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The age of onset of tuberculous meningitis with miliary tuberculosis is younger. IGRAs may be the preferred test for suspected tuberculous meningitis with miliary tuberculosis with negative etiological examination.

Key words: tuberculosis, meningeal, tuberculosis, pulmonary, interferongamma release assay； diagnosis