广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2013年
12期
1620-1622
,共3页
卢祥婵%黄爱春%何华伟%李雪琴%朱庆东%阮光靖%伍秋云%覃伟%韦柳迎%吴锋耀
盧祥嬋%黃愛春%何華偉%李雪琴%硃慶東%阮光靖%伍鞦雲%覃偉%韋柳迎%吳鋒耀
로상선%황애춘%하화위%리설금%주경동%원광정%오추운%담위%위류영%오봉요
获得性免疫缺陷综合征%新型隐球菌脑膜炎%鞘内注药%两性霉素B%氟康唑
穫得性免疫缺陷綜閤徵%新型隱毬菌腦膜炎%鞘內註藥%兩性黴素B%氟康唑
획득성면역결함종합정%신형은구균뇌막염%초내주약%량성매소B%불강서
AIDS%Novel cryptococcal meningitis%Intrathecal injection%Amphotericin B%Fluconazol
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。
目的：觀察不同治療方案治療艾滋病閤併新型隱毬菌腦膜炎（ CM ）的臨床療效。方法將艾滋病閤併CM患者46例分為兩組，觀察組25例採用兩性黴素B和氟康唑靜脈滴註，同時輔以兩性黴素B加地塞米鬆鞘內註藥；對照組21例僅採用兩性黴素B和氟康唑靜脈滴註，觀察兩組患者的療效。結果經過6週治療，觀察組中臨床癥狀明顯好轉，複查腦脊液墨汁染色試驗陰性17例（68．0％）；死亡4例，病死率16．0％；臨床癥狀好轉，但複查腦脊液墨汁染色試驗仍暘性4例。對照組中臨床癥狀明顯好轉，複查腦脊液墨汁染色試驗陰性11例（52．4％）；死亡6例，病死率28．6％；臨床癥狀好轉，但複查腦脊液墨汁染色試驗仍暘性4例。死亡病例CD4＋T細胞計數＜100箇/μl。兩組病死率及治療後腦脊液墨汁染色陰轉率比較，差異均無統計學意義（ P＞0．05）。結論 CD4＋T細胞計數低下的艾滋病閤併CM患者病死率高，全身應用抗真菌藥物的同時輔以鞘內註藥的療效未見明顯優勢。
목적：관찰불동치료방안치료애자병합병신형은구균뇌막염（ CM ）적림상료효。방법장애자병합병CM환자46례분위량조，관찰조25례채용량성매소B화불강서정맥적주，동시보이량성매소B가지새미송초내주약；대조조21례부채용량성매소B화불강서정맥적주，관찰량조환자적료효。결과경과6주치료，관찰조중림상증상명현호전，복사뇌척액묵즙염색시험음성17례（68．0％）；사망4례，병사솔16．0％；림상증상호전，단복사뇌척액묵즙염색시험잉양성4례。대조조중림상증상명현호전，복사뇌척액묵즙염색시험음성11례（52．4％）；사망6례，병사솔28．6％；림상증상호전，단복사뇌척액묵즙염색시험잉양성4례。사망병례CD4＋T세포계수＜100개/μl。량조병사솔급치료후뇌척액묵즙염색음전솔비교，차이균무통계학의의（ P＞0．05）。결론 CD4＋T세포계수저하적애자병합병CM환자병사솔고，전신응용항진균약물적동시보이초내주약적료효미견명현우세。
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 cerebrospinal fluid India ink staining were still positive.The CD4+T cell counting of all the death was <100 /μl.No significant difference was found in the mortality and the negative conversation rate of cerebrospinal fluid Indiainkstaining after treatment between two groups (P>0.05).Conclusion AIDS patients with CM with low CD 4 +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 .
