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目的探讨获得性免疫缺陷综合征(艾滋病)合并结核病及隐球菌脑膜炎的临床特点。方法对11例艾滋病合并结核病及隐球菌脑膜炎患者临床资料进行分析。结果低热9例,咳痰10例,胸痛8例,呼吸困难5例,发作性头痛3例,精神异常1例,视乳头水肿6例,视网膜出血1例,克氏征阳性4例。血型播散型肺结核2例,浸润型肺结核6例,结核性胸膜炎3例。头颅CT表现为脑膜强化3例,低密度区3例,脑实质肿胀1例,脑积水1例,脑室、脑池系统轻度扩大1例,小脑半球、颞叶异常信号灶2例。痰涂片抗酸杆菌阳性4例,培养阳性7例。好转6例,死亡5例。结论临床表现多样,易合并其他机会性感染,疗效差,病死率高。
Objective To investigate the clinical features of acquired immunodeficiency syndrome (AIDS) combined with tuberculosis and cryptococcal meningitis. Methods Clinical data of 11 AIDS patients with tuberculosis and cryptococcal meningitis were analyzed. Results 9 cases of low fever, sputum in 10 cases, 8 cases of chest pain, respiratory distress in 5 cases, 3 cases of paroxysmal headache, mental abnormalities in 1 case, papilledema in 6 cases, retinal hemorrhage in 1 case, Kirschner symbol positive in 4 cases. 2 cases of blood group disseminated tuberculosis, 6 cases of infiltrative pulmonary tuberculosis, 3 cases of tuberculous pleurisy. Head CT showed 3 cases of meningeal enhancement, 3 cases of low density, 1 case of brain swelling, 1 case of hydrocephalus, 1 case of cerebral ventricle and cistern system, 2 cases of abnormal cerebellar hemispheres and temporal lobe. Sputum smear acid-fast bacilli positive in 4 cases, positive culture in 7 cases. 6 cases improved, 5 cases died. Conclusions Various clinical manifestations, easy to merge other opportunistic infections, poor efficacy, high mortality.