AIDS并发隐球菌脑膜炎103例脑脊液分析和CD4关系的研究

Analysis of relationship of 103 cases AIDS complicated with cryptococcus meningitis cerebrospinal fluid and CD4

目的通过对艾滋病(AIDS)合并新生隐球菌脑膜炎患者的脑脊液情况分析,探讨该病的脑脊液变化及和外周血CD4+T淋巴细胞计数(以下简称CD4)的关系,为采取进一步预防措施和停药时机寻找依据。方法回顾总结103例AIDS合并新生隐球菌脑膜炎患者的实验室资料和临床特征,以及其脑脊液变化和CD4的关系等。结果 AIDS患者合并新生隐球菌脑膜炎时颅内压升高显著,脑脊液变化显著,病死率高(20.39%),几乎所有患者CD4都小于200/mm3,外周血HIV-RNA460000-1600000copies/ml。结论 AIDS并发新生隐球菌脑膜炎患者CD4低下,外周血HIV病毒复制活跃,颅内压显著升高、脑脊液蛋白显著升高、糖和氯显著降低,死亡率高,预后不良。对于CD4小于100/mm3患者持续采取二级预防治疗是必要的。

Objective Through analyzing the cerebrospinal fluid of AIDS complicated with cryptococcus meningitis,to discuss the changes of cerebrospinal fluid and the relationship between CD4 of the peripheral blood,To take further measures to prevent and stop taking time looking for evidence.Methods To review and summarize the laboratory data and clinical features of 103 cases about AIDS complicated with cryptococcus meningitis,Analyze the changes and the relationship between the CD4 and cerebrospinal fluid,etc.Results When the patient of AIDS complicated with cryptococcus meningitis,intracranial pressure increase significantly,cerebrospinal fluid change significantly,high fatality rate（20.39%）,CD4 of the patients were less than 200/mm3 almost all,HIV-RNA 460000-1600000copies/ml in peripheral blood.Conclusions CD4 of AIDS c.neoformans meningitis patients almost all less than 200/mm3.Among them whose CD4 is less than 100/mm3 accounted for 91.92%,HIV replication active in peripheral blood,this group of patients cerebrospinal fluid change even more significant：Significantly increased intracranial pressure,cerebrospinal fluid significantly increased protein,sugar and chlorine significantly reduced,a high mortality rate,unfavourable prognosis.For less than 100/mm3 CD4 continued to take the prevention and treatment of patients with secondary is necessary.