CAJ | 학술논문

目的：探讨艾滋病合并新型隐球菌性脑膜炎的临床特征。方法对19例艾滋病合并新型隐球菌性脑膜炎患者的临床资料进行回顾性分析。结果19例患者临床表现以头痛（100％）、恶心／呕吐（94．7％）、发热（78．9％）、颈强直（84．2％）为主。7例CSF蛋白升高，10例CSF葡萄糖下降及11例CSF压力升高。 CD4＋细胞计数平均值为（58．9±27．8）／mm3。影像学检查显示多为脑积水、脑梗死、脑萎缩和脑疝。两性霉素B、两性霉素B脂质体、氟康唑和氟胞嘧啶的使用率为31．6％、21．1％、47．4％和47．4％，仅2例接受抗逆转录病毒治疗。19例患者误诊率为31．6％，死亡率为21．1％。结论艾滋病合并新型隐球菌性脑膜炎起病隐匿，临床表现不典型，误诊率较高，及早诊断并早期使用抗真菌／抗逆转录病毒治疗有助于控制其发展。
목적：탐토애자병합병신형은구균성뇌막염적림상특정。방법대19례애자병합병신형은구균성뇌막염환자적림상자료진행회고성분석。결과19례환자림상표현이두통（100％）、악심／구토（94．7％）、발열（78．9％）、경강직（84．2％）위주。7례CSF단백승고，10례CSF포도당하강급11례CSF압력승고。 CD4＋세포계수평균치위（58．9±27．8）／mm3。영상학검사현시다위뇌적수、뇌경사、뇌위축화뇌산。량성매소B、량성매소B지질체、불강서화불포밀정적사용솔위31．6％、21．1％、47．4％화47．4％，부2례접수항역전록병독치료。19례환자오진솔위31．6％，사망솔위21．1％。결론애자병합병신형은구균성뇌막염기병은닉，림상표현불전형，오진솔교고，급조진단병조기사용항진균／항역전록병독치료유조우공제기발전。
Objective To observe the clinical features of AIDS coinfected with cryptococcus meningitis. Methods The clinical data of 19 AIDS patients coinfected with cryptococcus meningitis were retrospectively analyzed.Results Among 19 patients, the main clinical manifestation including headache (100.0%), nausea/vomiting (94.7%), fever (78.9%) and neck stiffness (84.2%).Seven cases revealed increased CSF protein, 10 cases showed depressed CSF glucose levels and 11 patients revealed elevated CSF pressures.The mean CD4+cell count was (58.9 ±27.8)/mm3.Imaging examination showed the neurological complications were hydrocephalus, cerebral infarction, cerebral atrophy and cerebral hernia.The usage rate of amphotericin B, amphotericin B liposome, fluconazole and fluorine cytosine was 31.6%, 21.1%, 47.4% and 47.4%, respectively.Only 2 cases received antiretroviral therapy.The misdiagnosis rate was 31.6%, and mortality rate was 21.1%.Conclusions AIDS coinfected with cryptococcus meningitis onsets hidden, with the clinical manifestation is atypical, and the misdiagnosis rate is higher.Early diagnosis and early usage of appropriate antifungal therapy/antiretroviral therapy can help to prevent the development of it.