艾滋病合并中枢神经系统病变32例临床分析  

Clinical analysis of 32 cases of AIDS complicated with central nervous system diseases

作　　者：朱大庆 胡典贵 敖建 ZHU Daqing;HU Diangui;AO Jian(Department of Infection, the Fifth People’s Hospital of Ganzhou City, Jiangxi Ganzhou 341000, China)

机构地区：[1]江西省赣州市第五人民医院感染科,江西赣州341000

出　　处：《上海医药》2019年第3期52-54,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:分析艾滋病患者中枢神经系统感染的临床特点及预后。方法:在298例艾滋病患者中选取32例(10.7%)艾滋病合并中枢神经系统感染的病例,回顾性分析其临床资料。结果:32例病例中,因发热入院的有19例(59.4%),头痛入院17例(53.1%),恶心呕吐入院12例(37.5%),颈部抵抗入院10例(31.3%)。25例(78.1%)患者CD4^+T淋巴细胞计数小于200/mm^3。3例(15%)头颅CT未见明显异常,隐球菌脑膜炎有10例(31.3%),原因不明的中枢神经系统感染7例(21.9%),结核性脑膜炎5例(15.6%),弓形虫脑炎4例(12.5%),脑梗死、脑白质病变和脑白质脱髓鞘各2例(6.3%),9例(28.1%)死亡。结论:艾滋病患者中枢病变以感染性疾病多见,多发生于免疫功能低下的患者中,主要为发热和颅内高压症状,病死率高。Objective: To analyze the clinical characteristics and prognosis of AIDS patients with central nervous system infection. Methods: Clinical data from 32 cases of AIDS complicated with central nervous system infection were retrospectively analyzed. Results: There were 19 cases (59.4%) admitted to hospital due to fever, 17 cases (53.1%) due to headache, 12 cases (37.5%) due to nausea and vomiting and 10 cases (31.3%) due to cervical resistance. There were 25 cases (78.1%) with CD4^+ T lymphocyte count less than 200/mm^3. Three cases (15%) showed no obvious abnormalities in the cranial CT. There were 10 cases (31.3%) with Cryptococcus meningitis, 7 cases (21.9%) with unknown central nervous system infection, 5 cases (15.6%) with tuberculous meningitis, 4 cases (12.5%) with toxoplasma encephalitis, 2 cases (6.3%) with cerebral infarction, 2 cases with leukoencephalopathy and 2 cases with demyelination of white matter and 9 deaths (28.1%). Conclusion: The infectious diseases are more common in AIDS patients with central lesions and occur mostly in the patients with low immune function, mainly in patients with fever and intracranial hypertension symptoms, and they have high mortality.

关 键 词：艾滋病 中枢神经病变 临床特点 

分 类 号：R512.91[医药卫生—内科学]