隐球菌脑膜炎患者感染后炎性反应综合征  

Postinfectious inflammatory response syndrome in patients with cryptococcal meningitis

作　　者：覃榜娥 刘佳[1] 彭福华[1] 江滢[1] Qin Bang′e;Liu Jia;Peng Fuhua;Jiang Ying(Department of Neurology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院神经病学科,广州510630

出　　处：《中华神经科杂志》2021年第11期1198-1202,共5页Chinese Journal of Neurology

基　　金：广东省自然科学基金面上项目(2016A030313228);国家自然科学基金面上项目(81671182)。

摘　　要：隐球菌性脑膜炎是一种常见的真菌性脑膜炎,在有效的抗真菌治疗过程中可能会出现异常的免疫反应,在人类免疫缺陷病毒(HIV)感染的患者中被称为免疫重建炎性综合征。类似现象也可见于既往免疫功能正常的非HIV感染患者中,在治疗过程中由于强烈的免疫反应而出现反常的临床和(或)影像学恶化,称之为感染后炎性反应综合征。该并发症目前并未引起关注,但却是非HIV感染患者预后不良的重要原因。尽早识别及治疗感染后炎性反应综合征具有重要意义,文中从其可能的发病机制、临床表现、影像学特征、风险预测、诊断、治疗与预后等方面进行了综述。Cryptococcal meningitis is a common fungal meningitis that may present with an abnormal immune response during effective antifungal therapy and is called immune reconstitution inflammatory syndrome in human immunodeficiency virus(HIV)-infected patients.Similar phenomenon can also be seen in non-HIV patients with normal immune function in the past.Paradoxical clinical and/or imaging deterioration occurs due to strong immune response during treatment,which is called post-infectious inflammatory response syndrome.At present,it has not attracted attention.This complication is an important cause of poor prognosis in non-HIV patients.Early identification and treatment of post-infectious inflammatory response syndrome is of great significance.This article will review its possible pathogenesis,clinical manifestations,imaging characteristics,risk prediction,diagnosis,treatment and prognosis.

关 键 词：脑膜炎 隐球菌性 免疫重建炎症综合征 感染后炎性反应综合征 副感染性炎性综合征 

分 类 号：R742.9[医药卫生—神经病学与精神病学]