目的 评价新型隐球菌性脑膜炎(隐脑)患者脑脊液中隐球菌荚膜多糖抗原和隐球菌特异性抗体(IgG)的检测对隐脑诊断和疗效观察的临床应用价值.方法 采用乳胶凝集试验和试管凝集试验检测28例隐脑患者脑脊液中隐球菌荚膜多糖抗原和隐球菌特异性抗体,并动态观察治疗期间抗原和抗体的变化.结果 初诊患者脑脊液中隐球菌荚膜多糖抗原效价主要集中在1:64～1:2 048,最高1:65536,经抗真菌药物治疗后,抗原多在1个月内下降,2个月90%患者下降至0.1例患者抗原效价下降之后又上升,提示耐药性出现应及时更换抗真菌药物.脑脊液中隐球菌抗体均为阴性.结论 乳胶凝集试验检测隐球菌荚膜多糖抗原对隐脑的诊断和疗效观察有重要临床应用价值,灵敏度高,操作简单,适合实验室推广.%Objective To investigate the diagnostic value and application value of the detection of cryptococcal capsu-lar polysaccharide antigen and IgG in cerebrospinal fluid ( CSF ) of patients with cryptococcal meningitis. Methods The capsular polysaccharide antigen and antibody in the CSF of 28 patients with cryptococcal meningitis were tested by latex agglutination test and tube agglutination test, and the dynamic changes of the antigen and antibody were observed during the treatment. Results The valence of capsular polysaccharide antigen among newly diagnosed patients was mainly 1: 64 ? 1: 2 048 , with 1: 65 536 being the highast. After the treatment of antifungal drug, the valence of most antigens decreased, and 90 % decreased to zero after two months. The antigen valence of one patient increased again after decrease, indicating the occurrence of drug tolerance and that antifungal drug should be changed timely. The antibodies in CSF were all negative. Conclusion The detection of capsular polysaccharide antigen by latex agglutination test is of great importance for the diagnosis and efficacy observation of cryptococcal meningitis with high sensitivity and simple operation. It should be recommended in laboratory.
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