CAJ | 학술논문

为了分析新型隐球菌性脑膜炎（隐脑）患儿脑脊液特点、治疗及转归情况，对2010年1月～2014年9月在郑州大学第一附属医院儿科收治的13例隐脑患儿的临床资料进行回顾性分析。结果显示，13例患儿脑脊液墨汁染色均找到隐球菌，首次脑脊液常规生化：白细胞计数增高，蛋白含量增高，糖含量明显减低；3周内各指标动态比较：脑脊液蛋白含量进行性增加。经两性霉素B（AmB）静点或鞘内注射联合氟康唑（FCZ）和5‐氟胞嘧啶（5‐FC）治疗后，8例治愈，2例好转，3例自动出院。因此，儿童隐脑确诊主要依赖墨汁染色找到隐球菌，对入院3周内脑脊液蛋白含量进行性增高者需高度警惕隐脑可能，一经确诊应及时、联合、长程、多途径抗真菌药物治疗。
위료분석신형은구균성뇌막염（은뇌）환인뇌척액특점、치료급전귀정황，대2010년1월～2014년9월재정주대학제일부속의원인과수치적13례은뇌환인적림상자료진행회고성분석。결과현시，13례환인뇌척액묵즙염색균조도은구균，수차뇌척액상규생화：백세포계수증고，단백함량증고，당함량명현감저；3주내각지표동태비교：뇌척액단백함량진행성증가。경량성매소B（AmB）정점혹초내주사연합불강서（FCZ）화5‐불포밀정（5‐FC）치료후，8례치유，2례호전，3례자동출원。인차，인동은뇌학진주요의뢰묵즙염색조도은구균，대입원3주내뇌척액단백함량진행성증고자수고도경척은뇌가능，일경학진응급시、연합、장정、다도경항진균약물치료。
To analyze the cerebrospinal fluid(CSF) features ,treatment and outcome of cryptococcus neoformans meningitis (CNM) in children .The clinical data of 13 children with CNM admitted to pediatric department of the First Hospital Affiliated to Zhengzhou University from January 2010 to September 2014 ,were analyzed retrospectively .Cryptococcus was found in CFS in 13 children (100% ) after ink staining smear .The first CSF cytology and biochemistry :white blood cell count increased ,protein content increased ,glucose content reduced obviously .The dynamic comparison of each index in 3 weeks:the protein content increased progressively .Among the 13 children receiving amphotericin B/fluconazole and flucytosine treatment ,8 cases cured ,2 cases were improved ,and 3 cases gave up any further treatment .Therefore , making a definite diagnosis of cryptococcus neoformans meningitis depend on CSF ink staining to find cryptococcus ,if the protein content increased progressively in 3 weeks ,the CNM should be highly suspected .Timely ,combined ,long‐time and multipath antifungal treatment should be given once confirmed .