摘要
目的观察不同治疗方案治疗艾滋病合并新型隐球菌脑膜炎(CM)的临床疗效。方法将艾滋病合并CM患者46例分为两组,观察组25例采用两性霉素B和氟康唑静脉滴注,同时辅以两性霉素B加地塞米松鞘内注药;对照组21例仅采用两性霉素B和氟康唑静脉滴注,观察两组患者的疗效。结果经过6周治疗,观察组中临床症状明显好转,复查脑脊液墨汁染色试验阴性17例(68.0%);死亡4例,病死率16.0%;临床症状好转,但复查脑脊液墨汁染色试验仍阳性4例。对照组中临床症状明显好转,复查脑脊液墨汁染色试验阴性11例(52.4%);死亡6例,病死率28.6%;临床症状好转,但复查脑脊液墨汁染色试验仍阳性4例。死亡病例CD4+T细胞计数<100个/μl。两组病死率及治疗后脑脊液墨汁染色阴转率比较,差异均无统计学意义(P>0.05)。结论 CD4+T细胞计数低下的艾滋病合并CM患者病死率高,全身应用抗真菌药物的同时辅以鞘内注药的疗效未见明显优势。
Objective To investigate the curative effects of different therapies for AIDS patients with novel cryptococcal meningitis（CM）. Methods Forty-six AIDS patients with CM were divided into two groups. The 25 patients in the observation group were given intravenous drip of amphotericin B and fluconazol as well as intrathecal injection of amphotericin B and dexamethasone. The 21 patients in the control group were given intravenous drip of amphotericin B and fluconazol. The effects of both groups were observed. Results After 6-week treatment, 17 （68.0%） patients of observation group were obviously better, whose results of cerebrospinal fluid India ink staining showed negative. Four patients of observation group were dead,and the mortality was 16.0%. Another 4 patients were better,but their results of cerebrospinal fluid India ink staining were positive. Eleven（52. 4% ） patients were obviously better in the control group,whose results of cerebrospinal fluid india ink staining showed negative.Six patients in the control group were dead,and the mortality was 28. 6%. Another 4 patients were better,but their results of cerebmspinal fluid India ink staining were still positive. The CD4＋T cell counting of all the death was 〈100/IA. No significant difference was found in the mortality and the negative conversation rate of cerebmspinal fluid Indiainkstaining after treatment between two groups （P 〉 0. 05）. Conclusion AIDS patients with CM with low CD4＋ T cell counting have a high mortality. The curative effects of antimycotic assisted by intrathecal injection for AIDS patients with CM aren＇t of obvious advantages.
出处
《广西医学》
CAS
2013年第12期1620-1622,共3页
Guangxi Medical Journal
基金
国家十二五传染病重大专项(2012ZX10001-003)
广西医药卫生科研课题(Z2011095)
广西南宁市科学研究与技术开发计划项目(20123165)
