新型隐球菌性脑膜炎与结核性脑膜炎临床对比分析

目的比较新型隐球菌性脑膜炎(CNM)与结核性脑膜炎(TBM)临床表现、脑脊液(CSF) 及影像学改变的差异,探讨2种不同病原体引起的脑膜炎的临床鉴别要点方法对25例CNM和67 例TBM患者的临床表现、CSF及影像学资料做回顾性分析结果CNM多呈亚急性或慢性起病,中、低度发热,神经损售的表现出现较晚,视乳头水肿及脑疝多见:TBM多呈急性或亚急性起病,高热多见,神经损害的表现出现较早,腱反射减弱TBM CSF白细胞计数及蛋白质较CNM高,氯化物较CNM低,葡萄糖较CNM高,CNM颅内压多明显升高,细胞分类两者差异无显著性影像学改变也有不同的特点,TBM 脑膜收变较CNM明显,脑积水多见且较重;CNM患者MRI可见血管周围腔隙扩大结论CNM和TBM 临床表现、CSF及影像学改变有一定的差异,这些特点是CNM和TBM鉴别诊断的有用信息

Clinical comparative analysis for patients with cryptococcal neoformans meningitis and tuberculous meningitis

Objective To compare the clinical manifestations, cerebrospinal fluid (CSF), and neuroimaging changes between cryptococcal neoformans meningitis (CNM) and tuberculous meningitis (TBM)in order to investigate the clinical differential points of meningitis caused by the two different pathogens. Methods The clinical manifestations, CSF, neuroimaging changes in 25 patients with CNM and 67 patients with TBM were analyzed retrospectively. Results The following items were considered significant: in CNM, the onset was subacute or chronic. The patients with CNM usually presented with middle and mild fever, higher intracranial hypertension accompanving papilledema, and lower glucose content of CSF. In TBM:The onset was usually acute or subacute. CSF pleocvtosis and absent tendon reflexes were the more common manifestations. Each meningitis had its own abnormal neuroimaging changes. Conclusion There are some differences in clinical svmptoms and signs, CFS and nueroimaging changes between CNM and TBM. which is important in diagnosing and differentiating CNM and TBM.