67例艾滋病合并新生隐球菌性脑膜脑炎临床分析

摘要/Abstract

摘要：

目的探讨艾滋病合并新生隐球菌性脑膜脑炎的临床特点及预后。方法回顾性收集2010年1月1日~2016年12月31日于北京佑安医院住院治疗的艾滋病合并新生隐球菌性脑膜脑炎患者，分析临床表现、实验室特点、治疗方案及转归。结果共67例患者确诊为艾滋病合并新生隐球菌性脑膜脑炎（男60例，女7例）。主要临床表现为头痛（74.6%），发热（47.8%）和恶心呕吐（40.3%），为最常见的3个症状。最常见的辅助检查异常是颅内压升高（78.9%），平均216.6（±100.3 mmH₂O）。实验室检查CD4⁺T细胞计数为53.7（±79.9）个/mm³。本组患者病死率29.9%%（20/67）。结论新生隐球菌性脑膜脑炎是艾滋病患者的严重并发症，降低隐球菌性脑膜脑炎病死率的关键是早期诊断及充分、规范的治疗，以减少隐球菌对脑实质的损伤，挽救患者生命。

关键词: 艾滋病, 隐球菌性脑膜脑炎, 临床特征

Abstract:

Objective To investigate the clinical characteristics of AIDS patients with cryptococcal meningitis. Methods We collected and analyzed the clinical data including clinical presentation, laboratory examination, therapeutic regimen and outcome on AIDS patients with cryptococcal meningitis from Beijing You'an Hospital during 1 January 2010 and 31 December 2016. Results There were 67 AIDS patients with cryptococcal meningitis in this study, including 60 male and 7 female. The most common clinical symptoms were headache (74.6%), fever (47.8%), nausea and vomiting (40.3%). Increased intracranial pressure was found in 78.9% patients, the mean pressure was 216.6 (±100.3 mm H₂O), and the baseline CD4⁺ T cell was 53.7 (±79.9)/mm3. The mortality rate was 29.9% (20/67). Conclusion Cryptococcal meningitis with high mortality rate was severe complication of AIDS. Early diagnosis and standard treatment was key to reduce injury of Cryptococcus on brain, and to save lives.

Key words: AIDS, cryptococcal meningitis, clinical characteristic

中图分类号:

R519.4

王莉琳, 李爱新, 杨雪, 汪雯, 吴昊. 67例艾滋病合并新生隐球菌性脑膜脑炎临床分析[J]. 中国真菌学杂志, 2019, 14(6): 342-345.

WANG Li-lin, LI Ai-xin, YANG Xue, Wang Wen, Wu Hao. Clinical analysis for 67 AIDS patients with cryptococcal meningitis[J]. Chinese Journal of Mycology, 2019, 14(6): 342-345.

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