摘要
目的:通过对13例新型隐球菌脑膜炎为首发的艾滋病(AIDS)进行临床分析,有助于引起公众对艾滋病与新型隐球菌脑膜炎关系的重视,以利于及时发现、确诊艾滋病。方法:对13例艾滋病合并新型隐球菌脑膜炎的病例进行回顾性分析。结果:共收住院新型隐球菌脑膜炎患者18例,其中13例被确诊为艾滋病并发新型隐球菌脑膜炎。T细胞亚群检测13例,CD4<100/mm311例,CD4101～200/mm32例,CD4<100/mm3占84.6%,平均CD436.8/mm3,13例艾滋病合并新型隐球菌脑膜炎患者中,好转2例,恶化6例,因新型隐球菌脑膜炎死亡5例,死亡率38.4%。结论:艾滋病患者合并新型隐球菌脑膜炎病情重,预后差,免疫力低下是引发隐球菌脑膜炎的主要因素,脑脊液病原学检查结果是诊断新型隐球菌脑膜炎的主要依据,诊断为新型隐球菌脑膜炎的病人应常行HIV检查。
Objective：The clinical data of 13 cases of acquired immune deficiency syndrome （AIDS） coinfected with Cyrptococcus neoformans meningitis were reviewed and analyzed to increase the understanding of AIDS and Cyrptococcus neoformans meningitis coinfection,in order to find and confirmed diagnosis of the AIDS earlier.Methods：Thirteen cases of AIDS coinfected with Cyrptococcus neoformans meningitis admitted from May 2008 to March 2010 were retrospectively reviewed.Results：Eighteen cases of Cyrptococcus neoformans meningitis patiens have been in our hospital since May 2008 to March 2010,of which,thirteen are diagnosised to be acquired immune deficiency syndrome （AIDS） coinfected with Cyrptococcus neoformans meningitis.T-lymphocyte subpopulation was tested in 13 cases：CD4100/ mm3 in 11 cases,CD4 101～200/mm3 2 cases.CD4100/mm3 84.6%,The mean cell count was 36.8/mm3.In the thirteen AIDS patients,two patients got better,six patients got worse,five patients died due to Cyrptococcus neoformans meningitis.The ratio of death occupies 38.4%.Conclusions：The clinical condition is serious with poor outcome in AIDS patients coinfected with Cyrptococcus neoformans meningitis.The main reason to cause Cyrptococcus neoformans meningitis is low immunity.Laboratory test result of CSF is the major evidence for diagnosis of Cyrptococcus neoformans meningitis.The patient diagnosised Cyrptococcus neoformans meningitis should be checked for HIV routinely.
关键词
AIDS
新型隐球菌脑膜炎
临床分析
Acquired immune deficiency syndrome
Cyrptococcus neoformans meningitis
Clinical analysis
