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目的 总结分析新型隐球菌性脑膜炎 (CM)的临床表现、实验室检查、CT和MRI影像学表现、治疗及预后 ,探讨CM的治疗进展。方法 采用回顾性方法分析 43例经脑脊液墨汁染色证实隐球菌脑膜脑炎患者的临床资料 ,并对CM的治疗进行总结。结果 首次CSF墨汁染色阳性率为 5 8 1%( 2 5 /4 3 ) ,第 2次墨汁染色阳性率为 3 0 2 %( 13 /4 3 ) ,7 0 %( 3 /4 3 )经CSF培养 ( +)而确诊。应用二性霉素B治疗的 3 2例病人中有 2 2例 ( 68 7%)临床治愈 ,4例无效而应用二性霉素B脂质体治愈 ,6例因脑疝死亡。结论 二性霉素B联合氟康唑静滴治疗CM仍然安全、有效 ,在二性霉素B治疗效果欠佳时可改用二性霉素B脂质体
Objective To summarize and analyze the clinical manifestations, laboratory tests, CT and MRI imaging manifestations, treatment and prognosis of cryptococcal meningitis (CM), and to explore the progress of CM treatment. Methods The clinical data of 43 patients with cryptococcal meningoencephalitis confirmed by cerebrospinal fluid ink stain were retrospectively analyzed and the treatment of CM was summarized. Results The positive rate of the first CSF ink was 581% (2 5/4 3), the second one was 32% (3/4 3), while the rate of the second ink staining was 70% (3/4 3) Training (+) and confirmed. Of the 32 patients treated with amphotericin B, 22 (68.7%) were clinically cured, 4 were ineffective and amphotericin B liposomes were cured, and 6 died of herniation. Conclusion Amphotericin B combined with fluconazole intravenous infusion of CM is still safe and effective in the treatment of amphotericin B may be less effective amphotericin B liposomes