系统性红斑狼疮合并隐球菌性脑膜炎临床分析

目的：探讨系统性红斑狼疮（SLE）合并隐球菌性脑膜炎的临床特点、诊断厦治疗，以提高对本病的认识和诊治水平。方法：时8例SLE合并隐球菌性脑膜炎（隐脑）病例的临床表现、脑脊液（cSF）特点和诊治经过进行回顾性分析。结果：SLE正患者出现隐脑时，病情隐匿，临床厦CSF系列生化检查呈非特异性，确诊所需时间2～16周，误诊率达50％，及时并重复进行CSF隐球菌乳胶凝集试验、涂片镜检厦培养是诊断的关键，以两性霉素B为主的抗真菌治疗效果较好，有效率100％。结论：SLE合并隐脑患者如能早期诊断并给予有效抗隐球菌治疗可显著改善预后。

Clinical Analysis of Cryptococcal Meningitis in Systemic Lupus Erythematosus

Objective:To study the characteristic,diagnosis and therapeutics of cryptococcal meningitis (CM) associated with systemic lupus erythematosus (SLE) and to improve the relevant diagnostic and therapeutics of the disease. Methods:8 patients with SLE, complicated by CM had been included in the study. The data of clinical manifestations,cerebrospinal fluid(CSF) findings and the whole process of diagnosis and treatment were reviewed. Results: The complication in SLE was always clinically latent. The nonspecific clinical and CSF laboratory findings may lead to misdiagnosis such as lupus encephalopathy or tuberculous meningitis. In our patients, the period from initiation of disease to diagnosis definitely was about 2-16 weeks. The rate of misdiagnosis was 50%. Timely and repeatedly CSF cryptococcus latex agglutination, culture or smear is the key to diagnosis. Antifungal therapy mainly with amphotericin B was effective and the efficiency was 100%. Conclusion:The early diagnosis and effective antifungal therapy could remarkably improve the prognosis of cryptococcal meningitis in SLE patients.