HIV/AIDS中枢神经系统感染患者的脑脊液检测结果分析

目的：分析HIV/AIDS合并中枢神经系统感染患者脑脊液的实验室检测结果，以提高对该病实验室检测的认识。方法回顾性分析我院2014年3月至2015年12月期间65例HIV/AIDS合并中枢神经系统感染患者首次送检的脑脊液实验室检查结果。结果65例HIV/AIDS合并中枢神经系统感染患者脑脊液有核细胞数(0.16±0.2)×109/L，>0.008×109/L 56例(86.15%)；葡萄糖(Glu)(2.71±1.17) mmol/L，<2.8 mmol/L 43例(66.22%)；氯化物(Cl）(117.3±7.7) mmol/L，<120 mmol/L 48例(74.84%)；总蛋白(TP)(792.7±505.8) mg/L，>450 mg/L 45例(69.23%)；乳酸脱氢酶(LDH)(44.1±42.3) U/L，>50 U/L 16例(24.62%)；脑脊液墨汁染色检出隐球菌35例(53.85%)；脑脊液培养出新型隐球菌30例(46.15%)；65例HIV/AIDS患者全部合并一种或多种机会感染，包括新型隐球菌、EB病毒、巨细胞病毒、梅毒、结核、卡氏肺孢子虫、口腔真菌、腹泻等，CD4+细胞<50×106/L与新型隐球菌感染密切相关。结论 HIV/AIDS合并中枢神经系统感染患者脑脊液主要表现真菌、中轻度炎性感染的特征，而且免疫力低下易合并一种甚至多重机会感染。

Analysis of results of cerebrospinal fluid detection in patients with HIV/AIDS and central nervous system infection

Objective To analyze the results of laboratory test of cerebrospinal fluid (CSF) in patients with HIV/AIDS complicated with central nervous system infection, and to improve the understanding of laboratory test of the disease. Methods The laboratory test results of the first-time submission of CSF in 65 patients with HIV/AIDS compli-cated with central nervous system infection in our hospital from March 2014 to December 2015 were retrospectively ana-lyzed. Results CSF routine results showed that the nuclear cell number of the 65 patients was (0.16±0.2)×109/L, with>0.008×109/L in 56 cases (86.15%). Biochemical results showed glucose (Glu) of (2.71±1.17) mmol/L with<2.8 mmol/L in 43 cases (66.22%), Chloride (Cl) of (117.3 ± 7.7) mmol/L with<120 mmol/L in 48 cases (74.84%), total protein (TP) of (792.7 ± 505.8) mg/L with >450 mg/L in 45 cases (69.23%), and lactate dehydrogenase (LDH) of (44.1 ± 42.3) U/L with>50 U/L in 16 cases (24.62%). Smear test results showed that the cryptococcal were detected in 35 cases (53.85%), and 30 cases (46.15%) of Cryptococcus neoformans were cultured by CSF. All HIV/AIDS patients were found to be com-plicated with one or more opportunistic infections, including Cryptococcus neoformans, epstein-barr (EB) virus, cytomega-lovirus, syphilis, tuberculosis, Pneumocystis carinii, oral fungal and diarrhea. CD4+cell<50×106/L was closely related to the infection of Cryptococcus neoformans. Conclusion Cerebrospinal fluid of patients with HIV/AIDS combined with central nervous system infection mainly show manifestations of fungal, moderate and mild inflammatory infection, and patients with low immunity tend to complicate with one or even multiple opportunistic infection.