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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、诊断及治疗,以提高对本病的认识和诊治水平。方法:对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患者出现隐脑时,病情隐匿,临床及CSF系列生化检查呈非特异性,确诊所需时间2-16周,误诊率这50％,及时并重复进行CSF隐球菌乳胶凝集试验、涂片镜检及培养是诊断的关键,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。
Objective: To investigate the clinical features, diagnosis and treatment of systemic lupus erythematosus (SLE) complicated with cryptococcal meningitis in order to improve the understanding and diagnosis and treatment of this disease. Methods: The clinical manifestations, cerebrospinal fluid (CSF) characteristics and diagnosis and treatment of 8 cases of cryptococcal meningitis complicated with cryptococcal meningitis were retrospectively analyzed. Results: In patients with SLE, cryptosporidium occured. The clinical and CSF biochemical tests were non-specific. The time required for diagnosis was 2-16 weeks and the rate of misdiagnosis was 50%. The Cryptococcus lactis lacteus agglutination test and smear Microscopic examination and culture is the key to diagnosis, with amphotericin B-based anti-fungal treatment is better, the efficiency of 100%. Conclusion: Patients with SLE combined with crypto-herniation can improve prognosis if they can be diagnosed early and treated with effective anti-cryptococcal therapy.