神经型布鲁菌病诊治专家共识(2025版)  

Expert consensus on the diagnosis and treatment of neurobrucellosis (2025 edition)

作　　者：中华医学会结核病分会结核性脑膜炎专业委员会 武力勇[2] 崔玥 叶红[2] 张婧[2] The Tuberculous Meningitis Subcommittee of the Tubercnlosis Branch of the Chinese Medical Association;Wu Liyong(不详;Department of Neurology,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]不详 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《中华医学杂志》2025年第5期346-357,共12页National Medical Journal of China

基　　金：北京市卫健委高层次公共卫生技术人才建设项目(领军人才-03-03);北京市医院管理中心“登峰”计划(DFL20240805)。

摘　　要：神经型布鲁菌病是布鲁菌累及神经系统所导致的一种疾病, 常作为布鲁菌病多系统受累的一部分出现, 也可能是布鲁菌病的唯一表现。国内外现有的人类布鲁菌病临床实践指南和共识发表年代久远, 且对于神经型布鲁菌病诊疗的推荐意见和说明有限, 已经越来越难以满足临床工作者和患者的诊疗需求。为全面提升我国临床工作者的神经型布鲁菌病诊治水平, 规范神经型布鲁菌病诊断与治疗的临床实践, 中华医学会结核病分会结核性脑膜炎专业委员会成立了神经型布鲁菌病诊治专家共识制订工作组, 严格遵循临床实践指南和共识制订方法学, 开展《神经型布鲁菌病诊治专家共识(2025版)》制订工作。本共识从流行病学史、临床表现、脑脊液表现、免疫学检测、病原学检测、影像学和电生理检查、诊断和鉴别诊断、治疗方案及预后评估9个方面共形成12条推荐意见, 并以此为基础形成中国神经型布鲁菌病的诊断标准和诊治流程。Neurobrucellosis is a neurological disorder caused by Brucella infection.It typically occurs as part of the multisystem involvement of brucellosis,or may also present as brucellosis.The existing clinical practice guidelines and expert consensus on human brucellosis are outdated and provide limited guidance specific to the diagnosis and management of neurobrucellosis,failing to meet the evolving needs of healthcare providers and patients.To comprehensively improve the diagnostic and therapeutic capabilities for neurobrucellosis in China,as well as to standardize clinical practice of diagnosis and treatment for neurobrucellosis,the Tuberculous Meningitis Subcommittee of the Tuberculosis Branch of the Chinese Medical Association established the Expert Consensus Development Working Group for Neurobrucellosis.Following rigorous methodologies for clinical practice guideline and consensus formulation,Expert consensus on the diagnosis and treatment of neurobrucellosis(2025 edition)was developed.This consensus outlines 12 recommendations in 9 aspects:epidemiological history,clinical manifestations,cerebrospinal fluid analysis,immunological testing,pathogen identification,imaging and electrophysiological assessments,diagnosis and differential diagnosis,therapeutic strategies,and prognostic evaluation.Based on these recommendations,the diagnostic criteria and diagnosis and treatment process for Chinese neuroblastoma have been developed.

关 键 词：布鲁杆菌病 神经型布鲁菌病 诊断准则 循证医学 

分 类 号：R516.7[医药卫生—内科学]