艾滋病合并新型隐球菌脑膜炎预后影响因素分析
Prognosis influential factor analysis of 27 patients of acquire immunodeficiency syndrome complicated with cryptococcal meningitis
郑芳 1肖刚 1王敏 1周国强1
作者信息
- 1. 410005 湖南省长沙市第一医院感染科
- 折叠
摘要
目的分析影响AIDS合并隐球菌脑膜炎(CM)预后的因素.方法回顾性分析27例AIDS合并CM患者的诊断、实验室检查、病原学检查、治疗及预后等资料，并将预后良好与预后不良进行比较分析.结果27例AIDS合并CM患者均在脑脊液中检出隐球菌.临床表现为发热、头痛及脑膜刺激征.CM患者CD4+T淋巴细胞均值40.2/mm3.27例AIDS合并CM患者均合并其他部位感染.6例死亡.在治疗初始时颅内压测定预后良好组(194.74±100.97)mmH2O与预后不良组(358.75±129.44)mmH2O比较差异有统计学意义(P<0.05)，联合两种敏感药物抗隐球菌与单用一种敏感药物效果有显著性差异.结论颅内压测定可作为判断AIDS合并CM患者预后的重要指标，早诊断、早治疗可降低病死率，及时予HAART可降低复发率.
Abstract
Objective To investigate the clinical features,prognosis and risk factors of patients of acquired immunodeficiency syndrome(AIDS) complicated with cryptococcal meningitis(CM). Methods Totally 27 patients of AIDS with CM who were hospitalized in Changsha Contagious Hospital were enrolled in the study. The clinical data including diagnosis, treatments and prognosis from all the patients were analyzed retrospectively. Results Among the 27 patients entrolled in the study, the positive rate of cerebrospinal fluid india ink smear or Crypotococcus neaformans culture was 100%. The most common symptoms were fever, headache and meningeal irritation sign. The average CD4+lymphocyte count was 40.2/mm3. All the patients showed Concomitant multiple organ infections. The mortality rate was as high as 22%. At the original therapy, the intracranial pressures were remarkably higher in the patients with unfavorable prognosis compared the patients with good prognosis, which was statistically different. Conclusion The results of intracranial pressure test can predict the prognosis. Prompt diagnosis and treatment can decrease death rate of patients. HAART in time of patients reduce relapse rate.
关键词
获得性免疫缺陷综合征/隐球菌,新型/脑膜炎,隐球菌性/预后/两性霉素-B/抗反转录病毒治疗/高效/CD4淋巴细胞计数Key words
AIDS/Crypotococcus/Neoformans/Meningitis/Cryptococcal/Amphotericin B/Antiretroviral therapy/Highly active/CD4 lymphocyte count引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据