以中枢神经系统症状为首发表现艾滋病79例分析  

作　　者：师金川 张忠东 晏定燕 崔亚辉 朱明利 刘寿荣 喻剑华 

机构地区：[1]杭州市西溪医院,310023

出　　处：《浙江临床医学》2021年第2期214-216,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医学会临床感染研究项目(2016ZYC-A42);杭州市医药卫生科技项目(ZD20200005);杭州市卫健委项目(2018A47)。

摘　　要：目的分析以中枢神经系统症状为首发表现艾滋病(AIDS)患者的临床特点,为其及时诊治提供依据。方法回顾性分析2018年2月至2020年2月收治的以中枢神经系统症状为首发表现的79例AIDS患者的临床资料。结果958例人类免疫缺陷病毒(HIV)/AIDS患者中,以中枢神经系统症状为首发表现者79例,发病率8.2%O主要的临床表现为发热、头痛、意识障碍、抽搐或癫痫、活动障碍、智力下降等。诊断为隐球菌性脑膜炎38例(48.1%),结核性脑膜炎9例(11.4%),弓形虫脑病8例(10.1%),进行性多灶性脑白质病5例(6.3%),神经梅毒3例(3.8%),巨细胞病毒性脑炎2例(2.5),脑梗死4例(5.1%),HIV相关性脑病1例(1.3%),原因不明中枢神经系统病变9例(11.4%)。结论以中枢神经系统症状为首发表现的AIDS患者病情复杂,早期诊断,及时治疗可以改善预后。Objective The clinical characteristics of AIDS patients with central nervous system(CNS)symptoms as the first manifestation were analyzed to provide basis for timely diagnosis and treatment of these patients.Methods The clinical data of 79 AIDS patients with CNS symptoms as the first manifestation admitted to Hangzhou Xixi Hospital from February 2018 to February 2020 were retrospectively analyzed.Results Among 958 HIV/AIDS patients,CNS symptoms were the first manifestation in 79 cases,with an incidence rate of 8.2%.The main clinical manifestations are fever,headache,consciousness disorder,convulsion or epilepsy,movement disorder,mental decline,etc.38 cases(48.1%)were diagnosed as cryptococcal meningitis,9 cases(11.4%)were diagnosed as tuberculous meningitis,8 cases(10.1%)were diagnosed as toxoplasmosis encephalopathy,5 cases(6.3%)were diagnosed as progressive multifocal leukoencephalopathy,3 cases(3.8%)were diagnosed as neurosyphilis,2 cases(2.5)were diagnosed as cytomegalovirus encephalitis,4 cases(5.1%)were diagnosed as cerebral infarction,1 case(1.3%)was diagnosed as HIV-related encephalopathy,and 9 cases(11.4%)were diagnosed as unexplained CNS lesions.Conclusion AIDS patients with CNS symptoms as the first manifestation have complicated conditions.Early diagnosis and timely treatment can improve the prognosis.

关 键 词：艾滋病 中枢神经系统症状 诊断 

分 类 号：R51[医药卫生—内科学]