论文部分内容阅读
目的通过比较脑脊液涂片墨汁染色镜检、脑脊液真菌培养与隐球菌抗原乳胶凝集试验,初步探讨隐球菌抗原乳胶凝集试验对隐球菌脑膜炎的诊断及治疗价值。方法收集四川大学华西医院脑膜炎患者共168例的病历资料及每例患者病程不同阶段的脑脊液标本共277份进行隐球菌抗原乳胶凝集试验。结果脑脊液隐球菌抗原检测诊断隐球菌脑膜炎敏感性100%(18/18),特异性99.3%(149/150)。隐球菌脑膜炎患者脑脊液治疗前抗原滴度为1:16~1:33768,平均滴度为1:(916.2±5.4),有效治疗后抗原滴度为1:4~1:512,平均滴度为1:(103.5±3.7),抗原滴度最高达1:33768的患者入院治疗5 d后死亡,入院时脑脊液抗原滴度较高的患者,抗原滴度下降也较慢。结论隐球菌抗原乳胶凝集试验可用于早期诊断隐球菌脑膜炎并可依据抗原滴度判断预后及疗效,值得进一步应用研究。
Objective To compare the diagnosis of cryptococcal meningitis with cryptococcal antigen latex agglutination test by comparing cerebrospinal fluid smear ink stain microscopy, cerebrospinal fluid fungal culture and cryptococcal antigen latex agglutination test. Methods A total of 277 cases of cerebrospinal fluid samples from 168 patients with meningitis in West China Hospital of Sichuan University were collected for latex agglutination test. Results The detection of cryptococcal antigen in CSF was 100% (18/18) and 99.3% (149/150) in the diagnosis of cryptococcal meningitis. The antigen titers of cerebrospinal fluid in patients with cryptococcal meningitis were 1: 16-1: 33768 before treatment, with an average titer of 1: 916.2 ± 5.4. After effective treatment, the titer of antigens was 1: 4-1: 512 and the average titer 1 (103.5 ± 3.7). Patients with antigen titers up to 1: 33768 died after 5 days of hospital admission. Patients with high cerebrospinal fluid antigen titers on admission had a slower decline in antigen titers. Conclusion Cryptococcal antigen latex agglutination test can be used for early diagnosis of cryptococcal meningitis and can be based on the antigen titer prognosis and efficacy, it is worth further study.