28例艾滋病合并隐球菌脑膜炎临床分析  

Clinical analysis of 28 cases of AIDS with cryptococcal encephalitis

作　　者：李虹[1,2] 关琦[1,2] 何云[1,2] 陈媛媛[1,2] 李超锋[1,2] 刘春礼 刘旭辉[1,2] 李琤[1,2] 孙燕[1,2] 赵清霞[1,2] 

机构地区：[1]河南省传染病医院 [2]郑州市第六人民医院感染一科,郑州450015

出　　处：《中国实用神经疾病杂志》2013年第20期15-17,共3页Chinese Journal of Practical Nervous Diseases

基　　金："十二五"科技重大专项(2012ZX10001-003-001)

摘　　要：目的 分析艾滋病（ADIS）合并隐球菌脑炎的临床特点,为其诊断及治疗提供参考.方法回顾性分析28例AIDS合并隐球菌脑炎的发病情况及临床特点.结果 28例AIDS合并隐球菌脑炎患者中,男17例,女11例;年龄22～60岁;入院时已经进行HAART治疗9例,未行HAART治疗19例;墨汁染色找到隐球菌者20例（20/28）,脑脊液乳胶凝集试验抗原阳性15例（15/15）.颅内压明显升高〉350 mmH2O 7例,腰大池置管引流术9例;给予两性霉素B联合氟康唑、氟胞嘧啶治疗21例,给予两性霉素脂质体联合氟康唑治疗3例,单用氟康唑治疗1例,未抗真菌治疗1例;好转21例,自动出院5例,死亡2例.结论 AIDS合并隐球菌脑炎的患者免疫力低下,脑脊液乳胶凝集试验抗原检测可提高隐球菌脑炎的诊断率,腰大池置管引流术可有效降低患者颅内压,提高治愈率,降低病死率.Objective To analyze the clinical features of AIDS merging cryptococcal encephalitis, to provide a reference for its diagnosis and treatment. Methods The incidence and clinical features of 28 eases of AIDS with eryptoeoeeal encephalitis were retrospeetivly analyzed. Results Aong 28 eases of AIDS with cryptocoeeal encephalitis patients, 17 eases were male and 11 eases were female, aged from 22 to 60 years old; Before admission nine eases received HAART, 19 eases did not undergo HAART; By ink staining, 20 eases were positive （20/28）, and eerebrospinal fluid latex agglutination test antigen positive in 15 eases （15/15）. Intraeranial pressure was ignificantly increased （〉350mmH20） in 7 eases, and 9 eases received lumbar cathe- ter drainage. 21 eases were given amphoteriein B Joint flueonazole and flueytosine treatment, 3 eases were given the the liposomal amphoteriein joint flueonazole treatment andlease received flueonazole only, while lease hadn＇t any antifungal treatment. After treatment ,21 eases were improved, 5 eases self -discharged and 2 eases were dead. Conclusion Patients of AIDS with eryptocoeeal encephalitis had low immunity, eerebrospinal fluid latex agglutination test for antigen detection can improve the diagnostic yield of eryptoeoceal encephalitis, and lumbar catheter drainage can be effective in reducing intracranial pressure in patients, improving the cure rate and reducing the death rate.

关 键 词：艾滋病 隐球菌脑炎 脑脊液 

分 类 号：R512.91[医药卫生—内科学]