新型隐球菌脑膜炎的治疗疗效观察  

Observation on the treatment efficacy of Cryptococcal neoformans meningitis

作　　者：[居辶]红珍[1] 徐凯进[1] 周志慧[1] 盛吉芳[1] 

机构地区：[1]浙江大学医学院附属第一医院传染病诊治国家重点实验室,杭州310003

出　　处：《中华传染病杂志》2010年第5期290-292,共3页Chinese Journal of Infectious Diseases

基　　金：基金项目：国家重点基础研究发展计划（973计划）资助项目（2007CB513004）

摘　　要：目的探讨新型隐球菌脑膜炎的治疗疗程对疾病预后的影响。方法回顾性分析30例新型隐球菌脑膜炎患者的临床资料，观察脑脊液新型隐球菌培养转阴时间，进一步分析两性霉素B（AmB）鞘内注射与非鞘内注射的疗效差异。数据采用t检验进行统计学分析。结果新型隐球菌转阴时间在11例AmB鞘内注射的患者为（22．73±10．00）d，在13例非鞘内注射的患者为（18．92±7．26）d，两者差异无统计学意义（t=0．172，P〉0．05）。在评价疗程对疾病预后影响的分析中，抗真菌治疗2周的有效率为45．8％，治疗6周的有效率达100．0％，治愈率为0；治疗结束（治疗3～4个月）的10例患者均有效。结论规范、足疗程的抗真菌治疗是提高新型隐球菌脑膜炎治愈率的关键。Objective To explore the influence of treatment duration on the prognosis of Cryptococcus neoforrnans meningitis（CNM）. Methods The clinical data of 30 patients with CNM were retrospectively analyzed. The time of Cryptococcus neoformans culture in cerebrospinal fluid turned to be negative were compared between patients with and without amphotericin B （AraB） endoneurilemma injection to determine whether endoneurilemma injection would make any difference on prognosis of CNM. Statistic analysis was performed by t test. Results The time of Cryptococcus neoformans culture in cerebrospinal fluid turned to be negative was （22. 73± 10. 00） days in 11 patients with Arab endoneurilemma injection compared to （18.92 ± 7.26） days in 13 patients without endoneurilemma injection. The difference was not statistically significant （t = 0. 172, P〉0.05）. The effective rate was 45.8% after 2-week anti Cryptococcus neoformans treatment, which increased to 100.0% after 6-week treatment. However, the curative rate at week 6 of treatment was 0. All ten patients who finished the treatment （three to four months＇ treatment） were acquired effective. Conclusion Treatment with standard dosage and adequate duration is crucial in improving the prognosis of Cryptococcus neoformans meningitis.

关 键 词：脑膜炎 隐球菌性 隐球菌 新型 注射 脊髓 抗真菌药 预后 

分 类 号：R515.2[医药卫生—内科学]