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目的探讨艾滋病病人合并机会性中枢神经系统感染(CNS)的发病率、临床特点及与CD+4T淋巴细胞(简称CD4细胞)的关系。方法回顾分析马拉维2013年3月至2013年9月收治的艾滋病病人中,CNS感染的病例资料,数据录入Excel进行处理。结果 1023例艾滋病病人中,合并机会性CNS 168例,发病率16.42%(168/1023)。其中合并隐球菌脑膜(脑)炎占47.02%(79/168),结核性脑膜(脑)炎占24.40%(41/168),弓形虫脑炎占19.05%(32/168),不明原因的CNS感染占7.74%(13/168),巨细胞病毒(CMV)性脑炎占1.79%(3/168)。检测的136例病人CD4细胞计数为8~493/mm3,平均为98.56/mm3。其中CD4细胞<50/mm3 22例,51~100/mm345例,101~200/mm3 44例,201~350/mm3 10例,>350/mm3 15例。118例好转出院,死亡50例,死亡率29.76%(50/168);以CD4细胞<100/mm3最为常见。结论机会性CNS感染是艾滋病晚期常见的并发症,表现复杂多样,病情重,主要发生于CD4细胞<200/mm3的病人,且病死率高。早诊断、及时治疗可以延长艾滋病病人的生命。
Objective To investigate the incidence, clinical features and the relationship with CD + 4T lymphocytes (CD4 cells) in patients with AIDS with central nervous system infection (CNS). Methods The data of cases with CNS infection among AIDS patients who were treated in Malawi from March 2013 to September 2013 were retrospectively analyzed. Data were entered into Excel for processing. Results Among 1023 AIDS patients, 168 cases were complicated with opportunistic CNS. The incidence was 16.42% (168/1023). Including cryptococcal meningitis accounted for 47.02% (79/168), tuberculous meningitis (brain) accounted for 24.40% (41/168), Toxoplasma encephalitis accounted for 19.05% (32/168), unexplained CNS infection accounted for 7.74% (13/168), cytomegalovirus (CMV) encephalitis accounted for 1.79% (3/168). The CD4 count of 136 patients tested was 8 ~ 493 / mm3 with an average of 98.56 / mm3. There were 22 CD4 <50 / mm3 cases, 51 ~ 100 / mm345 cases, 101 ~ 200 / mm3 44 cases, 201 ~ 350 / mm3 10 cases and> 350 / mm3 15 cases. 118 cases were discharged and discharged, 50 cases died, the mortality rate was 29.76% (50/168); the most common was CD4 cell count <100 / mm3. Conclusions The opportunistic CNS infection is a common complication of advanced AIDS. The performance is complicated and varied. The most serious illness occurs mainly in patients with CD4 cells <200 / mm3, and the case fatality rate is high. Early diagnosis, timely treatment can extend the lives of AIDS patients.