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目的:评价利福平耐药实时荧光定量核酸扩增技术（GeneXpert）联合结核感染T淋巴细胞酶联免疫斑点试验（T-SPOT.TB）诊断结核性脑膜炎（TBM）的价值。方法:回顾性分析2017年3月至2019年12月沈阳市胸科医院70例TBM患者（TBM组）和30例非TBM患者（非TBM组）的临床资料。患者均行GeneXpert和T-SPOT.TB检测。以脑脊液MGIT960液体培养结果作为金标准，评估GeneXpert和T-SPOT.TB诊断TBM的情况。结果:TBM组GeneXpert、T-SPOT.TB、两种方法并联及两种方法串联的阳性率均明显高于非TBM组[27.14%（19/70）比0、72.86% （51/70）比46.67%（14/30）、78.57%（55/70）比46.67%（14/30）和21.43%（15/70）比0]，差异有统计学意义（n P<0.01或<0.05）。两种方法并联诊断TBM的灵敏度最高为78.57%，准确度达71.00%；而两种方法串联诊断TBM的特异度为100.00%，误诊率为0。n 结论:GeneXpert和T-SPOT.TB两种方法并联诊断TBM的灵敏度最高，两种方法串联及GeneXpert单独检测的特异度均高达100.00%，两种方法串联可降低TBM的误诊率，并联可降低漏诊率。“,”Objective:To evaluate the diagnostic value of rifampin resistance real-time fluorescent quantitative nucleic acid amplification technology (GeneXpert) combined with T cell spot test of tuberculosis infection (T-SPOT.TB) in tuberculous meningitis (TBM).Methods:The clinical data of 70 TBM patients (TBM group) and 30 non-TBM patients (non-TBM group) in Shenyang Chest Hospital from March 2017 to December 2019 were retrospectively analyzed. All patients were detected by GeneXpert and T-SPOT.TB. The results of MGIT960 liquid culture of cerebrospinal fluid were used as the gold standard to evaluate the diagnosis of TBM by GeneXpert and T-SPOT.TB.Results:The positive rates of GeneXpert and T-SPOT.TB in parallel and in series in TBM group were significantly higher than those in non-TBM group: 27.14% (19/70) vs. 0, 72.86% (51/70) vs. 46.67% (14/30), 78.57% (55/70) vs. 46.67% (14/30) and 21.43% (15/70) vs. 0, and there were statistical differences (n P<0.01 or <0.05). The sensitivity and accuracy of two methods in parallel in TBM diagnosis were 78.57% and 71.00% respectively. The specificity and misdiagnosis rate of two methods in series in TBM diagnosis were 100.00% and 0 respectively.n Conclusions:The sensitivity of GeneXpert and T-SPOT.TB in parallel is the highest in TBM diagnosis. The specificity of the two methods in series and GeneXpert alone is as high as 100.00%. The two methods can reduce the misdiagnosis rate of TBM in series and reduce the rate of missed diagnosis in parallel.