89例新型隐球菌性脑膜炎的临床分析

目的：分析两性霉素B和（或）氟康唑联合氟胞嘧啶治疗新型隐球菌性脑膜炎（CNM）的疗效。方法回顾性分析89例住院CNM患者的临床资料及治疗情况。结果患者首发症状多表现为头痛（89/89，100.0%）和呕吐（62/89，69.7%）。发热、头痛、呕吐和脑膜刺激征为该病主要临床表现。CNM确诊前怀疑为结核性脑膜炎19例，占21.3%；怀疑为巨细胞病毒脑炎8例，占8.9%。经两性霉素B和（或）氟康唑联合氟胞嘧啶抗真菌治疗后，66例好转、治愈，20例自动出院，3例死亡。结论 CNM易出现误诊，两性霉素B和（或）氟康唑联合氟胞嘧啶抗真菌治疗疗效显著。

Clinical analysis of 89 case with Cryptococcus neoformans meningitis

Objective To investigate the therapeutic effects of patients with Cryptococcus neoformans meningitis （CNM） treated with amphotericin B/lfueonasole and lfucytosine. Methods Clinical manifestations, therapy and prognosis of 89 patients with CNM were analyzed, retrospectively. Results Most patients had headache （89/89, 100%） and vomiting （62/89, 69.7%） as the ifrst symptoms, whose main clinical manifestations included fever, headache, vomiting and signs of meningeal irritation. There were 19 cases （21.3%） were misdiagnosed as tuberculous meningitis and 8 cases （8.9%） were misdiagnosed as giant cell virus encephalitis before conifrmed diagnosis. Among the 89 patients receiving amphotericin B/lfueonasole and lfucytosine, there were 66 cases cured, 20 cases discharged due to exacerbation, and 3 casese dead in hospital. Conclusions CNM appears misdiagnosed easily. The analysis indicates that amphotericin B/lfueonasole and lfucytosine therapy remains highly effective in treatment of CNM.