Objective To explore the diagnostic value of ESAT-6 of CSF mononuclear cells combined with CSF LAM-IgG on tuberculous meningitis.Methods From January 2010 to August 2014 in the First Affiliated Hospital of Xinxiang Medical College, 49 inpatients with tuberculous meningitis were selected as A group, 28 inpatients with purulent meningitis were selected as B group, 24 inpatients with viral meningitis were selected as C group, and 60 healthy cases admitted to the hospital for physical examination were selected as D group.All of the four groups underwent CSF cytology examination, CSF biochemical examination, ESAT-6 of CSF mononuclear cells detection and CSF LAM-IgG detection, ROC curve was drawn to evaluate the diagnostic value of ESAT-6 of CSF mononuclear cells, CSF LAM -IgG and combination of both on diagnosis of tubercular meningitis.Results There were statistically significant differences of WBC, neutrophil percentage, lymphocyte percentage and monocyte percentage of CSF among the four groups ( P <0.05 ) . There were statistically significant differences of protein content, sugar content and chloride content of CSF among the four groups ( P <0.05 ) . The AUC of ESAT -6 of CSF mononuclear cells in diagnosing tuberculous meningitis was 0.876 〔95%CI (0.764, 0.910)〕, the sensitivity was 89.80%, the specificity was 96.43%; the AUC of CSF LAM-IgG in diagnosing tuberculous meningitis was 0.852 〔95%CI (0.560, 0.890)〕, the sensitivity was 55.10%, the specificity was 100.00%; the AUC of combination of both in diagnosing tuberculous meningitis was 0.924 〔95%CI (0.850, 1.000)〕, the sensitivity was 92.00%, the specificity was 97.30%.Conclusion Combination of ESAT -6 of CSF mononuclear cells and CSF LAM -IgG has certainly high diagnostic value on tuberculous meningitis, which is helpful to improve the sensitivity.%目的：探讨脑脊液单核细胞早期分泌性抗原靶－6（ESAT－6）联合脑脊液阿拉伯糖甘露糖脂（LAM）抗体对结核性脑膜炎的诊断价值。方法选择2010年1月—2014年8月在新乡医学院第一附属医院住院的结核性脑膜炎患者49例作为结核性脑膜炎组，化脓性脑膜炎患者28例作为化脓性脑膜炎组，病毒性脑膜炎患者24例作为病毒性脑膜炎组，同期体检健康者60例作为正常对照组。各组受检者均进行脑脊液细胞学检查和生化检查，脑脊液单核细胞ESAT－6及LAM抗体检测，并通过绘制ROC曲线评价脑脊液单核细胞ESAT－6、脑脊液LAM抗体及二者联合（并联试验）对结核性脑膜炎的诊断效能。结果4组受检者脑脊液白细胞计数、中性粒细胞分数、淋巴细胞分数及单核细胞分数比较，差异均有统计学意义（ P＜0.05）。4组受检者脑脊液蛋白含量、糖含量、氯化物含量比较，差异均有统计学意义（P＜0.05）。脑脊液单核细胞ESAT－6诊断结核性脑膜炎的曲线下面积（AUC）为0.876〔95％CI （0.764，0.910）〕，取最佳临界值时灵敏度为89.80％、特异度为96.43％；脑脊液LAM抗体诊断结核性脑膜炎的AUC为0.852〔95％CI （0.560，0.890）〕，取最佳临界值时灵敏度为55.10％、特异度为100.00％；两者联合诊断结核性脑膜炎的AUC为0.924〔95％CI （0.850，1.000）〕，取最佳临界值时灵敏度为92.00％、特异度为97.30％。结论脑脊液单核细胞ESAT－6联合脑脊液LAM抗体对结核性脑膜炎的诊断效能较高，有助于提高诊断结核性脑膜炎的灵敏度。
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