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目的探讨艾滋病(AIDS)合并弓形虫脑病(弓脑)的临床表现、诊疗方法及预后。方法回顾性分析诊断为艾滋病合并弓脑病例的临床表现、诊断、治疗及预后。结果2003年12月初至2008年9月底,广西疾病预防控制中心综合门诊的所有1 400例艾滋病病毒(HIV)感染者/AIDS病人中,20例被临床诊断为弓脑,总发病率为1.4%。主要的临床表现包括发热、头痛、抽搐、呕吐、中枢系统局灶征及精神状态改变等。典型的影像学改变是单个或多个脑部圆形或不规则病灶,伴或不伴环状增强影。该病的完全治愈率为45%,其余均效果不佳,有神经系统后遗症或死亡。结论HIV/AIDS合并弓脑发病率远低于结核、马尔尼菲青霉菌病等,但有较高的致病性和致死性。弓形虫IgG的检测应更普遍使用。
Objective To investigate the clinical manifestations, diagnosis and treatment methods and prognosis of AIDS complicated with toxoplasmosis. Methods The clinical manifestations, diagnosis, treatment and prognosis of cases of AIDS complicated with arcuata were retrospectively analyzed. Results From the beginning of December 2003 to the end of September 2008, 20 out of the total 1 400 cases of HIV / AIDS patients in Guangxi Center for Disease Control and Prevention General Outpatient were diagnosed as bowel, the total incidence was 1.4% . The main clinical manifestations include fever, headache, convulsions, vomiting, central nervous system focal signs and changes. A typical imaging change is a single or multiple brain round or irregular lesions, with or without annular enhancement shadow. The complete cure rate of the disease was 45%, the rest are ineffective, nervous system sequelae or death. Conclusions The morbidity of HIV / AIDS complicated with bowel is much lower than that of tuberculosis and Penicillium marneffei, but it has higher pathogenicity and lethality. Toxoplasma IgG detection should be more commonly used.