艾滋病并发新型隐球菌脑膜炎28例临床分析

摘要

Objective To analyze the clinical features of AIDS - associated Cryptococcal meningitis and the factors that influencing prog-nosis. Methods A retrospective analysis of 28 cases of AIDS associated with Cryptococcal meningitis was performed,the analyzing factors inclu-ding etiological examination,laboratory tests,diagnosis,treatment and other clinical data were performed. According to the prognosis of these pa-tients,they were divided into good prognosis and poor prognosis groups. These above data of two groups were compared. Results All 28 patients presented with headache to this department. Eighteen patients (64. 3％)had fever,13 (46. 4％)had signs of meningeal irritation,26 (92. 9％) had CD4 + T lymphocytes 750 mg、两性霉素B剂量>1500 mg、CD4+T淋巴细胞>20/μl、颅内压<272 mmH2 O与1年归因病死率减少显著相关.结论 艾滋病合并新型隐球菌脑膜炎患者多以头痛为主诉,伴发热及颅内压增高等表现多见;应用两性霉素B、CD4计数、颅内压测定可作为判断艾滋病合并新型隐球菌脑膜炎患者预后的重要指标,早诊断、早治疗可降低病死率.