两性霉素B联合氟胞嘧啶治疗艾滋病合并隐球菌脑膜炎患者的疗效分析

The impact of clinical symptoms and treatment effect of amphotericin B combined with flucytosine in the treatment of AIDS combined with Cryptococcal neoformans meningitis

目的探讨两性霉素B联合氟胞嘧啶对艾滋病合并隐球菌脑膜炎患者临床症状及治疗效果的影响。方法选取内江市第一人民医院收治的46例艾滋病合并隐球菌脑膜炎患者为研究对象,采用数字表法分为观察组和对照组各23例,观察组采用两性霉素B联合氟胞嘧啶治疗,对照组采用两性霉素B联合氟康唑治疗。比较两组临床症状、病死率及隐球菌转阴率。结果观察组头痛、恶心呕吐、抽搐、意识障碍症状明显低于对照组(78.26%vs100.00%,56.52%vs 78.26%,17.39%vs 39.13%,13.04%vs 30.43%);脑脊液隐球菌转阴率明显高于对照组(78.26%vs 56.52%);病死率明显低于对照组(8.70%vs 21.74%),差异均有统计学意义(P<0.05)。结论两性霉素B联合氟胞嘧啶有助于改善临床症状,提高脑脊液中隐球菌转阴率,降低病死率。

Objective To study the clinical symptoms and treatment effect of amphotericin B combined with flucytosine in the treatment of AIDS combined with Cryptococcal neoformans meningitis. Methods 46 cases patients with AIDS combined with cryptococcal meningitis were divided into observation group and the control group. Observation group was given with amphotericin B combined with flucytosine; control group was given amphotericin B combined with fluconazole.Clinical symptoms, fatality rate and cryptococcus overcast rate were compared between two groups. Result Headache,nausea and vomiting, convulsions and consciousness disorder symptoms were significantly lower than those of control group（78.26% vs 100.00%,56.52% vs 78.26%,17.39% vs 39.13%,13.04% vs 30.43%）; CSF cryptococcus overcast rate was significantly higher than that of control group（78.26% vs 56.52%）; Case fatality rate was significantly lower than that of control group（8.70% vs 21.74%）. Conclusion Amphotericin B combined with flucytosine helping to improve the clinical symptoms, improve Cryptococcus turn rate, and reduce the case fatality rate.