艾滋病合并隐球菌性与结核性脑膜炎多重感染的临床及影像学特征分析

R445.2; 目的 探究艾滋病(aquired immunodeficiency syndrome,AIDS)合并隐球菌性脑膜炎(cryptococcal meningitis,CM)与结核性脑膜炎(tuberculous meningitis,TBM)多重感染患者的临床与MRI影像特点,为临床诊治提供参考.方法 回顾性分析上海市公共卫生临床中心2015年9月至2021年10月收治的39例艾滋病合并隐球菌性与结核性脑膜炎(AIDS/CM/TBM)患者的临床资料,并比较其与61例艾滋病合并隐球菌性脑膜炎(AIDS/CM)患者和42例艾滋病合并结核性脑膜炎(AIDS/TBM)患者的临床表现、实验...

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Published in复旦学报(医学版) Vol. 49; no. 4; pp. 499 - 506
Main Authors 马琼, 严琴琴, 石秀东, 侯钦国, 施裕新
Format Journal Article
LanguageChinese
Published 复旦大学附属公共卫生临床中心放射科 上海 201508%复旦大学附属公共卫生临床中心放射科 上海 201508 01.07.2022
上海市影像医学研究所 上海 200032
Subjects
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ISSN1672-8467
DOI10.3969/j.issn.1672-8467.2022.04.004

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Abstract R445.2; 目的 探究艾滋病(aquired immunodeficiency syndrome,AIDS)合并隐球菌性脑膜炎(cryptococcal meningitis,CM)与结核性脑膜炎(tuberculous meningitis,TBM)多重感染患者的临床与MRI影像特点,为临床诊治提供参考.方法 回顾性分析上海市公共卫生临床中心2015年9月至2021年10月收治的39例艾滋病合并隐球菌性与结核性脑膜炎(AIDS/CM/TBM)患者的临床资料,并比较其与61例艾滋病合并隐球菌性脑膜炎(AIDS/CM)患者和42例艾滋病合并结核性脑膜炎(AIDS/TBM)患者的临床表现、实验室指标及头颅MRI影像特征等方面的差异.结果 AIDS/CM/TBM组患者头痛的发生率高于AIDS/TBM组,抽搐、视力障碍、意识障碍的发生率高于AIDS/CM组和AIDS/TBM组,差异均有统计学意义(P<0.05).32例(82.0%)AIDS/CM/TBM患者CD4+T淋巴细胞计数≤100个/μL.AIDS/CM/TBM组白细胞计数、脑脊液蛋白水平均高于AIDS/CM组,脑脊液糖水平低于AIDS/CM组;脑脊液压力和脑脊液氯化物水平高于AIDS/TBM组,差异均有统计学意义(P<0.05).34例(87.2%)AIDS/CM/TBM患者头颅MRI检查存在病灶,多发为主,呈脑膜炎和脑膜脑炎表现,脑叶病灶发生率高于AIDS/CM组,血管周围间隙扩大或胶样假囊的出现率低于AIDS/CM组,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示头痛、意识障碍及脑脊液糖≤1.85 mmol/L与AIDS/CM/TBM多重感染相关(P=0.009,0.005,0.002).结论 AIDS/CM/TBM临床表现更重,实验室检查变化更显著,头颅MRI表现以脑膜炎和脑膜脑炎为主;头痛、意识障碍及脑脊液糖≤1.85 mmol/L对其诊断具有提示意义,有助于临床及时干预.
AbstractList R445.2; 目的 探究艾滋病(aquired immunodeficiency syndrome,AIDS)合并隐球菌性脑膜炎(cryptococcal meningitis,CM)与结核性脑膜炎(tuberculous meningitis,TBM)多重感染患者的临床与MRI影像特点,为临床诊治提供参考.方法 回顾性分析上海市公共卫生临床中心2015年9月至2021年10月收治的39例艾滋病合并隐球菌性与结核性脑膜炎(AIDS/CM/TBM)患者的临床资料,并比较其与61例艾滋病合并隐球菌性脑膜炎(AIDS/CM)患者和42例艾滋病合并结核性脑膜炎(AIDS/TBM)患者的临床表现、实验室指标及头颅MRI影像特征等方面的差异.结果 AIDS/CM/TBM组患者头痛的发生率高于AIDS/TBM组,抽搐、视力障碍、意识障碍的发生率高于AIDS/CM组和AIDS/TBM组,差异均有统计学意义(P<0.05).32例(82.0%)AIDS/CM/TBM患者CD4+T淋巴细胞计数≤100个/μL.AIDS/CM/TBM组白细胞计数、脑脊液蛋白水平均高于AIDS/CM组,脑脊液糖水平低于AIDS/CM组;脑脊液压力和脑脊液氯化物水平高于AIDS/TBM组,差异均有统计学意义(P<0.05).34例(87.2%)AIDS/CM/TBM患者头颅MRI检查存在病灶,多发为主,呈脑膜炎和脑膜脑炎表现,脑叶病灶发生率高于AIDS/CM组,血管周围间隙扩大或胶样假囊的出现率低于AIDS/CM组,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示头痛、意识障碍及脑脊液糖≤1.85 mmol/L与AIDS/CM/TBM多重感染相关(P=0.009,0.005,0.002).结论 AIDS/CM/TBM临床表现更重,实验室检查变化更显著,头颅MRI表现以脑膜炎和脑膜脑炎为主;头痛、意识障碍及脑脊液糖≤1.85 mmol/L对其诊断具有提示意义,有助于临床及时干预.
Author 马琼
侯钦国
严琴琴
施裕新
石秀东
AuthorAffiliation 上海市影像医学研究所 上海 200032;复旦大学附属公共卫生临床中心放射科 上海 201508%复旦大学附属公共卫生临床中心放射科 上海 201508
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Author_FL SHI Xiu-dong
SHI Yu-xin
YAN Qin-qin
HOU Qin-guo
MA Qiong
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DocumentTitle_FL Analysis of clinical and imaging characteristics of cryptococcal meningitis and tuberculous meningitis co-infection in AIDS patients
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Keywords 艾滋病(AIDS)
隐球菌性脑膜炎(CM)
鉴别诊断
结核性脑膜炎(TBM)
多重感染
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上海市影像医学研究所 上海 200032
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Snippet R445.2; 目的 探究艾滋病(aquired immunodeficiency syndrome,AIDS)合并隐球菌性脑膜炎(cryptococcal meningitis,CM)与结核性脑膜炎(tuberculous meningitis,TBM)多重感染患者的临床与MRI影像特点,为临床诊治提供参考.方法...
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Title 艾滋病合并隐球菌性与结核性脑膜炎多重感染的临床及影像学特征分析
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