AIDS合并弓形虫脑病76例临床分析

Clinical Analysis of 76 AIDS Patients with Toxoplasmic Encephalitis

目的了解AIDS合并弓形虫脑病的临床特点,为临床诊断提供参考.方法对云南省传染病专科医院2012年1月至2014年6月收治的76例AIDS合并弓形虫脑病患者进行临床分析.结果 76例患者CD4+T淋巴细胞平均值为(71±18.23)个/μL,76例患者中血液Ig G抗体阳性18例(23.7%),IgM抗体阳性6例(7.9%),脑脊液中Ig G抗体阳性9例(11.8%),IgM抗体阳性5例(6.6%).影像学检查示多发低密度病灶,增强扫描后呈环状或螺旋状增强影像.结论 CD4+T淋巴细胞水平明显低下的AIDS患者易发生弓形虫脑病,Ig G、IgM检测阳性率较低,影像学检查有一定的特征性.尽早开始HAART以及在CD4+T淋巴细胞<200个/μL的AIDS患者中预防性用药可减少弓形虫脑病的发生.

Objective This study was aimed to investigate the clinical characteristics of AIDS patients with toxoplasmic encephalitis （TE） in order to provide clinical reference for its diagnosis. Methods 76 AIDS patients with TE treated in Yunnan Province hospital of infectious diseases from January 2012 to June 2014 were selected as subjects, and their clinical data were analyzed. Results CD4＋T lymphocyte cell counts of all cases was 71 ± 18.23/μL. In blood of the 76 cases, positive IgG and IgM anti-toxoplasma antibodies were found in 18 cases （23.7%） and 6 cases （7.9%） , respectively. In cerebrospinal fluid, positive IgO and IgM antibodies were found in 9 cases （11.8% ） and 5 cases （6.6%） , respectively. Imaging examination displayed lameUar low density umbra, which showed ring-like performance after enhancement. Conclusion There is a significant relationship between low CD4＋T lymphocyte cell counts and the infection of TE in AIDS patients. Anti-toxoplasma IgG and IgM positive rates are low in AIDS patients with TE, but imaging examination has certain characteristics. This study suggests that the incidence rate of TE infection in AIDS patients with CD4＋T lymphocyte cell counts below 200/μL can be reduced if early highly active antiretroviral therapy （HAART） and preventive medication will be required.