隐球菌性脑膜炎与结核性脑膜炎的临床对比分析

目的比较隐球菌性脑膜炎（隐脑）与结核性脑膜炎（结脑）临床表现、实验室检查的差异，探讨两种脑膜炎的鉴别诊断规律。方法对19例隐脑和19例结脑患者的一般情况、临床表现、实验室检查进行回顾性分析。结果与结脑组相比较，隐脑组患者体温、颅压增高较明显，跟底病变及听力下降等脑神经受损症状出现早且多，但颈项强直不及结脑组患者明显。隐脑组患者脑脊液（CSF）中氯化物含量降低不及结脑组患者明显，但葡萄糖含量降低较结脑组患者显著。结论根据患者的临床表现特点及CSF检查结果的不同，可以对结核性脑膜炎及隐球菌性脑膜炎进行初步的临床诊断，避免两类脑膜炎的误诊。

Comparative analysis of patients with cryptococcal meningitis and tuberculous meningitis

Objective To compare the differences in clinical manifestations and laboratory profiles between cryptococcal meningitis and tuberculous meningitis, and explore the regularity of differential diagnosis of the two meningitis. Methods The general health state, clinical manifestations, and laboratory findings in 19 patients with cryptococcal meningitis and 19 patients with tuberculous meningitis were analyzed retrospectively. Results Compared with tuberculous meningitis group, the body temperature and pressure in the subarachnoid cavity in cryptococcal meningitis group rised more significantly, more cranial nerves injuries appeared earlier, but nuchal rigidity was less obvious. The chloride in CSF in cryptococcal meningitis group decreased less obviously, but the glucose level more notablely than that in tuberculous meningitis group. Conclusion According to the clinical manifestations and CSF findings, preliminary diagnosis of cryptococcal neoformans and tuberculous meningitis can be made so as to avoid misdiagnosis of the two kinds of meningitis.