新型隐球菌性脑膜炎43例临床分析  

Clinical Analysis of 43 Cases of Cryptococcus Meningitis

作　　者：张三泉[1] 王劲[2] 曾抗[1] 李健华[1] 

机构地区：[1]第一军医大学南方医院皮肤性病科,广东广州510515 [2]第一军医大学南方医院影像中心

出　　处：《中国医师杂志》2003年第8期1073-1074,1113,共3页Journal of Chinese Physician

摘　　要：目的　总结分析新型隐球菌性脑膜炎 (CM)的临床表现、实验室检查、CT和MRI影像学表现、治疗及预后 ,探讨CM的治疗进展。方法　采用回顾性方法分析 43例经脑脊液墨汁染色证实隐球菌脑膜脑炎患者的临床资料 ,并对CM的治疗进行总结。结果　首次CSF墨汁染色阳性率为 5 8 1%( 2 5 /4 3 ) ,第 2次墨汁染色阳性率为 3 0 2 %( 13 /4 3 ) ,7 0 %( 3 /4 3 )经CSF培养 ( +)而确诊。应用二性霉素B治疗的 3 2例病人中有 2 2例 ( 68 7%)临床治愈 ,4例无效而应用二性霉素B脂质体治愈 ,6例因脑疝死亡。结论　二性霉素B联合氟康唑静滴治疗CM仍然安全、有效 。Objective To search the clinical manifestations,data of laboratory examination, features of CT and MRI, therapy, prognosis in order to evaluate the progress in therapy of patients with crypotococcus meningitis(CM).Methods The findings of clinical features were analyzed and summarized for therapy of 43 CM cases identified with India-ink capsule staining.Results Primary positive rates of India-ink capsule staining were 58 1%(25/43), secondary positive rates were 30 2%(13/43),7 0%(3/43),patients diagnosed with cultivate positive. Clinical cure was achieved in 22 of 32 patients (68 7%) treated with amphotericin B, 4 patients of without efficacy using amphotericin B were cured by liposomal amphotericin B treatment.6 patients was died from cerebral hernia.Conclusions It is indicated that amphotericin B and fluconazole are effective and well tolerated in treatment of crypotococcus meningitis. If amphotericin B should inefficiency therapy of CM,liposomal amphotericin B would be consider.

关 键 词：隐球菌性脑膜炎 二性霉素B 二性霉素B脂质体 脂质体 

分 类 号：R519[医药卫生—内科学]