隐球菌性脑膜炎78例脑脊液细胞学改变  

The change of cerebrospinal fluid cytology in 78 patients with cryptococcal neoformans meningitis

作　　者：易芳[1] 谭利民[2] 肖波[1] 杨欢[1] 梁静慧[1] 冯莉[1] 毕方方[1] 张宁[1] 

机构地区：[1]中南大学湘雅医院神经内科,长沙410008 [2]中南大学湘雅二医院神经内科

出　　处：《脑与神经疾病杂志》2010年第2期135-136,共2页Journal of Brain and Nervous Diseases

摘　　要：目的总结隐球菌性脑膜炎(CNM)的脑脊液标本细胞学检测资料,提高对隐球菌性脑膜炎的诊断。方法总结近6年(2003年1月至2008年7月)我院CNM的临床资料、脑脊液诊断情况。结果共78例患者,常规涂片墨汁染色首检阳性者48例(61.5%),26例(33.3%)重复送检时发现隐球菌,余4例(5.1%)墨汁染色始终呈阴性,靠隐球菌培养确诊。55例(70.5%)行细胞学检查的患者首次送检即直接找到隐球菌。结论脑脊液细胞学较常规涂片墨汁染色首检隐球菌阳性率更高。CNM的诊断有赖于脑脊液墨汁染色、细胞学检查、隐球菌培养等多种手段相结合以提高其阳性率。Objective To summarize the data of cerebrospinal fluid（CSF）cytology in patients with cryptococcal neoformans meningitis and improve the level of diagnosis.Methods 78 patients（from 2003.1-2008.7）were analyzed for general information and CSF data.Results 48 of 78 patients were found cryptococcus in the first common Chinese ink stain（61.5%）,while 26 were found in the second or third stain（33.3%）and 4 patients were negative all along.55 patients were found cryptococcus directly in their first detection of CSF（70.5%）.Conclusion Cerebrospinal fluid cytology was better than Chinese ink stain in detecting cryptococcus for the first time,and we should combine the methods of ink stain,cytology,fungi cultivation and so on to increase the detection rate.

关 键 词：脑膜炎 隐球菌 脑脊液 细胞学 

分 类 号：R446.14[医药卫生—诊断学]