目的：提高临床医生对神经型布鲁菌病（neuro-brucellosis，NB）的诊治水平，改善患者预后。方法：收 集并分析2024年1月～2024年9月在首都医科大学附属北京地坛医院确诊的4例NB患者的临床资料。结 果：4例NB患者均有明确的流行病学史。临床多表现为脑膜炎、脊髓炎等。所有患者均行腰椎穿刺检查，3 例患者脑脊液压力升高，4例白细胞数升高，4例患者蛋白升高，3例糖减低。所有患者血清布鲁杆菌凝集试 验阳性，3例患者行脑脊液布鲁杆菌凝集试验阳性。4例患者给予在利福平和多西环素基础上组成的三联 或四联抗布鲁菌治疗方案。结论：神经型布鲁氏菌病的临床表现复杂多样，早发现、早诊断利于患者预后， 延误诊断的患者预后差，可留有后遗症。

To improve clinicians' diagnostic and therapeutic skills for neurobrucellosis (NB) and enhance patient outcomes. Methods: Clinical data of 4 patients with NB diagnosed at Beijing Ditan Hospital, Capital Medical University, from January 2024 to September 2024 were retrospectively analyzed. Results: All 4 patients had a clear epidemiological history. Clinical manifestations included meningitis, myelitis, and other neurological symptoms. Lumbar puncture was performed in all cases. Cerebrospinal fluid (CSF) analysis revealed elevated pressure in 3 patients, increased white blood cell counts in all 4, elevated protein levels in all 4, and reduced glucose levels in 3. Serum Brucella agglutination tests were positive in all patients, and CSF Brucella agglutination tests were positive in 3. All patients received triple or quadruple anti-Brucella therapy based on rifampicin and doxycycline. Conclusion: Neurobrucellosis presents with complex and diverse clinical features. Early detection and diagnosis are critical for improving prognosis, while delayed diagnosis leads to poor outcomes and potential long-term sequelae.