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目的 探究舍曲林(SERT)及其联合两性霉素B(AmB)抗不同基因型的隐球菌临床分离株的效果.方法 通过多序列位点分型(MLST)的方法对63株脑脊液隐球菌临床分离株进行基因鉴定,并参照微量稀释法(M27-A3及M27-S4)对菌株进行体外单药[AmB、5-氟胞嘧啶(5-FC)、SERT]药敏实验及以分数抑菌浓度指数(FICI)为判定指标的联合药敏(AmB+SERT;AmB+5-FC)实验.结果 63株隐球菌中有59(93.6％)株为新型隐球菌,基因型均为VNI,其余4(6.4％)株为格特隐球菌,其中有3(4.8％)株为VGI,1(1.6％)株为VGⅡ.在AmB、5-FC、SERT的单药药敏实验中,敏感性降低的菌株均为VNI型,但各个基因型的药敏结果差异没有统计学意义(P>0.05).在联合药敏实验中,AmB+SERT与AmB+5-FC有相似的协同作用比例(98.4％vs.92.1％),且前者的FICI更小(P0.05). AmB+SERT had similar synergistic effects with AmB+5-FC(98.4％vs.92.1％) in combined susceptibility testing ,and the former had a smaller FICI (P<0.001). Conclusion Sertraline against different genotypes of Cryptococcus had strong antifungal activity in vitro,combined with AmB could play a synergistic bactericidal effect. This showed that sertraline had the potential for the treatment of cryptococcal meningitis.