AIDS合并巨细胞病毒脑炎临床分析

目的探讨艾滋病（AIDS）合并巨细胞病毒脑炎（CMVE）的临床特点及治疗转归。方法回顾性地收集北京地坛医院2011年3月-2013年2月收治的8名合并CMVE的AIDS病人的临床资料,分析其症状和体征、辅助检查、病毒学检查及治疗转归情况。结果 8例病人脑脊液CMV脱氧核糖核酸（DNA）或CMV-IgM抗体阳性,但血清中CMV DNA可阴性。7例CD4＋淋巴细胞计数均〈30/μL,轻症、早期病人可不伴随神经精神症状,头颅核磁共振（MRI）检查可无异常,7例患者经抗CMV及高效抗反转录病毒治疗（HAART）后均获得临床好转。结论合并CMVE易出现在CD4＋淋巴细胞计数低的AIDS病人中,及时对可疑病人进行脑脊液CMV DNA或CMV-IgM抗体检查,有利于早期诊断和治疗。

Clinical analysis on cytomegalovirus encephalitis in AIDS patients

Objective To explore the clinical characteristics,treatments and prognosis of cytomegalovirus encephalitis（CMVE）in patients with acquired immune deficiency syndrome（AIDS）.Method To retrospectively collect clinic records and analyze symptoms,diagnostic examination,virology,treatments and prognosis of eight AIDS patients with CMVE in Beijing Ditan Hospital from March 2011to February 2013.Results Although CMV deoxyribonucleic acid（DNA）of serum may be negative,positive CMVDNA or CMV-IgM in CSF were observed among eight cases.Mild or early-phase cases may lack of psychiatric symptoms,MRI may be normal.Seven cases regressed after combined treatment of anti-CMV and HAART.Conclusion CMVE usually occurs in AIDS patients with low CD4＋counts.It is necessary to detect CMVDNA or CMV-IgM in CSF for timely diagnosis and treatment.