CAJ | 학술논문

目的：探讨隐球菌荚膜多糖抗原检测对 HIV感染继发隐球菌脑膜炎患者诊断及治疗观察的意义。方法2012年1月至2013年5月华西医院 HIV感染继发隐球菌脑膜炎患者23例。采集隐球菌脑膜炎治疗前后的脑脊液和血清标本，作墨汁染色并用 APl20CAUX真菌鉴定试剂条鉴定到种，行隐球菌荚膜抗原检测，并对其中13例患者治疗前后脑脊液和血清标本中荚膜抗原滴度变化进行配对t检验。结果治疗后脑脊液和血清标本中隐球菌荚膜抗原滴度下降，与治疗前比较，差异均有统计学意义(P<0.05)；13例患者隐球菌脑膜脑炎治疗有效，但真菌培养及涂片均显示阴性后，部分患者隐球菌荚膜抗原仍为阳性。结论隐球菌荚膜抗原检测有利于提高 HIV感染继发隐球菌脑膜炎患者的早期诊断；抗原滴度能用来判断疗效，但不能作为治愈指标。
목적：탐토은구균협막다당항원검측대 HIV감염계발은구균뇌막염환자진단급치료관찰적의의。방법2012년1월지2013년5월화서의원 HIV감염계발은구균뇌막염환자23례。채집은구균뇌막염치료전후적뇌척액화혈청표본，작묵즙염색병용 APl20CAUX진균감정시제조감정도충，행은구균협막항원검측，병대기중13례환자치료전후뇌척액화혈청표본중협막항원적도변화진행배대t검험。결과치료후뇌척액화혈청표본중은구균협막항원적도하강，여치료전비교，차이균유통계학의의(P<0.05)；13례환자은구균뇌막뇌염치료유효，단진균배양급도편균현시음성후，부분환자은구균협막항원잉위양성。결론은구균협막항원검측유리우제고 HIV감염계발은구균뇌막염환자적조기진단；항원적도능용래판단료효，단불능작위치유지표。
Objective To discuss the significance and therapy monitoring of detection cryptococcal capsular polysaccharide anti-gen in HIV-positive patients with secondary cryptococcal meningitis.Methods Cerebrospinal fluid and serum samples of 23 HIV-positive patients with secondary cryptococcal meningitis were collected,retrospective analysis was conducted in the capsular antigen titer changes data which from 23 patients with the cerebrospinal fluid(CSF)and serum samples before and after treatment.And the capsular antigen in 1 3 patients before and after treatment of CSF and serum specimens were compared in matching t test.Results The CSF and serum samples before and after treatment of cryptococcal capsular antigen titer decreased both with statistical signifi-cance(P<0.01),but by effective treatment and fungal culture and smears were negative in the 13 patients,the cryptococcal capsu-lar antigen was still positive.Conclusion Cryptococcal capsular antigen test could help improve HIV-infected patients with crypto-coccal meningitis secondary to early diagnosis,it could be used to determine the efficacy of antigen titer,but not as a cure indicator.