目的 探讨艾滋病(AIDS)合并结核性脑膜炎(TM)患者的临床特点,提高对其疾病特征的认识.方法 回顾分析2007年9月至2016年7月36例AIDS合并TM住院患者的临床资料,并与32例AIDS合并化脓性脑膜炎患者资料进行比较.结果 36例AIDS合并TM患者临床症状不典型,不同程度的体重减轻、发热、头痛和脑膜刺激征,所有患者均存在多种合并症.CD4+T淋巴细胞计数平均(167.18±92.38)个/μl与AIDS合并化脓性脑膜炎CD4+T淋巴细胞均数(165.68±92.95)个/μl比较,差异无统计学意义(P>0.05).两组患者均进行脑脊液常规检查,比较发现脑脊液中白细胞、多核细胞、腺苷脱氨酶,差异有统计学意义(P<0.05).36例AIDS合并TM患者经抗病毒和抗结核治疗12个月后,好转28例.结论 艾滋病合并结核性脑膜炎患者的临床表现不典型,诊断治疗较为困难,脑脊液检查可以帮助明确诊断,积极治疗可改善近期预后.%Objective To investigate the clinical features of AIDS patients complicated by tuberculous meningitis. Methods Retrospective analysis of hangzhou xixi hospital nearly eight years(2007.9~2016.7) the clinical data of 36 cases of hospitalized patients with AIDS merged TM,and compared with 32 cases of AIDS merged fester sex meningitis. Results 36 cases of clinically asymptomatic patients with AIDS merged TM:different degrees of weight loss,fever,headache and meningeal stimulation,all patients with a variety of complications. CD4+ T lymphocyte were counted an average of 167.18±92.38(cells/μL). Fester sex meningitis with AIDS CD4+ T lymphocyte mean an average of(165.68±92.95(cells/μL)was no statistical difference (P>0.05). Compared cerebrospinal fluid routine inspection,two groups of patients were found in the cerebrospinal fluid white blood cells,multinucleated cells,adenosine deaminase significant differences(P<0.05) were statistically significant,the antiviral and anti-tuberculosis treatment after 12 months, 28 cases improved. Conclusion AIDS with tuberculous meningitis patients with atypical clinical manifestations,diagnosis and treatment are difficult, cerebrospinal fluid examination may help diagnosis,active treatment can improve prognosis in the near future.
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