隐球菌性脑膜炎28例临床分析

Clincal analysis of 28 patients with cryptococcus meningitis meningitis

目的 分析 2 8例隐球菌性脑膜炎的临床资料 ,以期提高对隐球菌性脑膜炎的认识。方法 回顾性总结近年 2 8例隐球菌性脑膜炎的临床表现、辅助检查、误诊情况及治疗。结果 隐球菌性脑膜炎误诊率高 ,采用二性酶素B(AMB)、氟康唑和 (或 ) 5 氟胞嘧啶联合治疗 ,总有效率为 6 4 .3%。 10例无效患者中 7例死于脑疝。结论 减少病死率的关键在于提高警惕 ,早期诊断 ,合理使用抗真菌药物。

Objective To improve the reccognition of cryptococcus meningitis throuth a clinical analysis of 28 cases. Methhods The clinical manifestation and examinations,misdiagnosis,and therapy of 28 patients with cryptococcus meningitis were analysed retrospectively.Result All 28 cases were treated with amphotericin B(AMB),fluconazole and /or 5 fluorocytosine (5 FU).The total effective rate was 64.3%,in which an ineffcient was observed in 10 patients,and 7 cases died from hernia cerebri.Conclusions The misdiagnosis rate of crypyococcus meningitis is high.It is important that earlier diagnosis and rational application of antifungal agent to decrease the mortality.AMB administered in combination with fluconazole and/or 5 FU is to be the first choice.