目的：探讨GeneXpert MTB/RIF检测技术在结核性脑膜炎（TBM）诊断中的应用价值。方法：收集疑 似TBM患者137例，采集患者脑脊液标本，运用抗酸染色法、培养法、GeneXpert MTB/RIF技术进行检测。 分别以临床诊断和培养法作为参考标准来评价GeneXpert MTB/RIF对TBM的诊断性能。结果：137例患者 中最终纳入 124 例（90.5%），临床诊断为 TBM 51 例，非 TBM73 例。以临床诊断为标准，GeneXpert MTB/ RIF、抗酸染色法、培养法在TBM组检测敏感度分别为25.5%（13/51）、3.9%（2/51）、17.6%（9/51），特异性均为 100%（73/73）。GeneXpert MTB/RIF 敏感性与培养法相比无差异（P=0.336），但显著高于抗酸染色法（P= 0.002）。若以结核杆菌培养法作为参考标准，GeneXpert MTB/RIF检测TBM的敏感性为88.9%（8/9），特异 性为100%（73/73）。13例经GeneXpert MTB/RIF检测阳性患者中均未检出利福平耐药，与传统药敏结果一 致。结论：GeneXpert MTB/RIF技术操作简便、快速，特异性高。

To evaluate the diagnostic value of GeneXpert MTB/RIF for diagnosis of tuberculous meningitis (TBM). Methods: A total of 137 patients with suspected TBM were prospectively recruited. Samples of cerebrospinal fluid were collected from all patients, and tested by acid fast staining, mycobacterial culture and GeneXpert MTB/RIF. The performance of GeneXpert MTB/RIF was evaluated by two reference standards, clinical diagnosis and mycobacterial culture, respectively. Results: Of the 137 enrolled subjects, 124 cases (90.5% ) had a final diagnosis, with 51 cases being diagnosed definitive TBM and 73 cases being diagnosed non-TBM. When clinical diagnosis was used as the reference standard, the sensitivities of GeneXpert MTB/RIF? acid fast staining ? mycobacterial culture were 25.5% (13/51) ? 3.9% (2/51) ? 17.6% (9/51), respectively. The specificities of the three methods were all 100%. The sensitivity of GeneXpert MTB/RIF was comparable to that of mycobacterial culture (P=0.336), and was significantly higher than that of acid fast staining (P=0.002). When mycobacterial culture was used as the reference standard, the sensitivity of GeneXpert MTB/RIF was 88.9%，and specificity was 100% . Rifampin resistance was not found in the 13 positive results of GeneXpert MTB / RIF assay, which was consistent with traditional drug susceptibility test. Conclusion: GeneXpert MTB / RIF is a simple and rapid diagnostic method with high specificity for Mtb detection