HIV抗体阳性与阴性隐球菌脑膜炎的临床对比分析

Clinical comparative analysis of positive and negative HIV antibody cryptococcal meningitis

目的探讨HIV抗体阳性与阴性隐球菌脑膜炎患者的脑脊液临床特点。方法回顾性分析2014年6月~2017年6月我院收治的53例隐球菌脑膜炎患者的临床资料,按照HIV抗体阳性和阴性分为两组,HIV抗体阳性组27例,HIV抗体阴性组26例。比较两组患者的临床表现、实验室检查指标及死亡率。结果 HIV抗体阳性组和HIV抗体阴性组患者的性别、就诊前病程比较,差异有统计学意义(P<0.05)。两组患者都以头痛、呕吐等为主要临床表现。两组患者的脑脊液蛋白、脑脊液细胞数、脑脊液糖、脑脊液LDH、脑脊液氯化物、血氯等指标比较,差异无统计学意义(P>0.05)。HIV抗体阳性患者的血淋巴细胞计数低于HIV抗体阴性组,差异有统计学意义(P<0.05)。两组患者的死亡率比较,差异无统计学意义(P>0.05)。在就诊前病程≤10 d的患者中,HIV抗体阳性组患者的死亡率高于HIV抗体阴性组,差异有统计学意义(P<0.05)。结论就诊前,HIV抗体阳性患者的病程短于HIV抗体阴性组患者,而两组患者的脑脊液检查及临床预后指标比较,差异无统计学意义,说明HIV阳性患者病情进展较快。

Objective To analyze the clinical characteristics of cryptococcal meningitis patients with positive and negative HIV antibody.Methods The clinical data of 53 patients with cryptococcal meningitis treated in our hospital from June 2014 to June 2017 were retrospectively analyzed.The patients were divided into two groups according to the positive and negative HIV antibody,HIV antibody positive group had 27 cases and HIV antibody negative group had 26 cases.The clinical manifestations,laboratory tests and death rate of the two groups were compared.Results The gender and preclinical course of HIV antibody positive group and HIV antibody negative group were compared,the differences were not statistically significant （P〉0.05）.Headache and vomiting were the main clinical manifestations in the two groups.The cerebrospinal fluid protein,cerebrospinal fluid cell count,cerebrospinal fluid saccharide,cerebrospinal fluid LDH,cerebrospinal fluid chloride,blood chlorine and other indicators were compared in the two groups,and the differences were not statistically significant （P〉0.05）.The blood lymphocyte count of patients in the HIV antibody positive group was lower than those of the HIV antibody negative group,and the difference was statistically significant （P〈0.05）. The death rate was compared between the two groups,and the difference was not statistically significant （P〉0.05）.In patients with preclinical course of less than 10 d,the death rate of patients in the HIV antibody positive group was lower than those of the HIV antibody negative group,and the difference was statistically significant （P〈0.05）.Conclusiou The preclinical course of cryptococcal meningitis in HIV antibody positive patients is shorter than that of HIV antibody negative group,but there is no significant difference between two groups in cerebrospinal fluid examination and clinical prognosis,which indicates that the disease progression of HIV-positive patients is faster.