摘要
目的分析艾滋病合并隐球菌病患者的临床特点、治疗及转归,提高对隐球菌病的认识。方法回顾性分析19例艾滋病合并隐球菌病患者的临床资料。结果本组19例患者,男女比例17:2。头痛、呕吐、发热是最为常见症状,颈项强直为常见体征。所有病例颅内压均升高(>180mmH_2O)。CD4+T淋巴细胞计数均有不同程度降低,平均值为35. 6个/μL。脑脊液墨汁染色涂片阳性率89. 5%,培养阳性率78. 9%。脑脊液白细胞数轻度升高或正常。19例患者经积极抗真菌治疗后,有12例治疗好转出院,有意识障碍、CD4+T淋巴计数过低、并发隐球菌败血症、脑脊液压力过高、脑脊液白细胞计数低者预后不佳。结论隐球菌病在艾滋病患者中较为常见,与患者免疫功能降低有关,早期诊断并给予有效的抗真菌治疗可改善预后。
Objective To analyze the clinical characteristics,treatment and prognosis of AIDS patients with Cryptococcosis,and to improve the understanding of Cryptococcosis.Methods The clinical data of 19 AIDS patients with cryptococcosis were analyzed retrospectively.Results In this group of 19 patients,the proportion of men and women was 17： 2.Headache,vomiting and fever were the most common symptoms,and neck rigidity was a common sign. Intracranial pressure was elevated in all cases（ 〉180 mmH2 O）.The CD4＋ T lymphocyte count decreased in varying degrees,with an average of 35. 6/μL.The positive rate of cerebrospinal ink stain smear was 89. 5% and the positive rate of culture was 78. 9%.The number of white blood cells in the cerebrospinal fluid was slightly elevated or normal.Of the 19 patients treated with active antifungal therapy,12 were cured and discharged,and the prognosis of patients with conscious disturbance,low CD4＋ T lymphatic count,cryptococcal sepsis,high cerebrospinal fluid pressure and low cerebrospinal fluid leukocyte count was poor. Conclusion Cryptococcosis is related to the decrease of immune function,more common in AIDS patients. Early diagnosis and effective antifungal therapy can improve the prognosis.
作者
李毅
杨凤
赵川
王容
王文平
蒋远明
Li Yi;Yang Feng;Zhao Chuan(The Suining City Center Hospital,Suining,Sichuan 629000,China)
出处
《四川医学》
CAS
2018年第9期1003-1007,共5页
Sichuan Medical Journal
基金
四川省卫生计生委科研项目(编号:150244)
关键词
获得性免疫缺陷综合征
机会性感染
隐球菌
新型隐球菌脑膜炎
acquired immunodeficiency syndrome
opportunistic infection
cryptococcus
cryptococcus neoformans meningitis
