【摘要】 目的 分析AIDS合并隐球菌脑膜炎（cryptococcal meningitis, CM）患者的临床特点。方法 采用横断面研究，收集首都医科大学附属北京佑安医院于2019年1月—2022年1月确诊并治疗的AIDS合并CM患者的临床特点、实验室检查结果及预后资料。结果 共纳入63例AIDS合并CM的病例。患者平均年龄（37.22±10.95）岁，CD4~+T淋巴细胞计数中位数为22个/μl。总病死率为15.9%(10/63)。63例患者中，死亡（死亡组）10例，中位生存时间5 d，正常出院（正常出院组）53例。分析结果显示死亡组的低CD4~+T淋巴细胞计数、合并隐球菌菌血症、颅内高压、白细胞计数升高及血小板计数降低发生率高于正常出院组（P均<0.05）。死亡组临床表现包括脑膜刺激征、颅神经受累、意识障碍的发生率高于正常出院组（P均<0.05）。结论 AIDS合并CM患者病死率较高，应针对高危人群加强宣教及隐球菌筛查，保持良好依从性，及时发现耐药，避免自行停药，便于早期诊断，早期干预。更多还原

【Abstract】 Objective To analyze the clinical characteristics of patients with acquired immunodeficiency syndrome(AIDS)complicated with cryptococcal meningitis(CM). Methods A cross-sectional study was conducted to collect clinical features, laboratory examination results and prognosis data of AIDS patients with CM who were diagnosed and treated in Beijing Youan Hospital affiliated to Capital Medical University from January 2019 to January 2022. Results A total of 63 cases of AIDS combined with CM were included. The average age of the patients was(37.22±10.95) years, with a median CD4~+ T lymphocytes count of 22 cells/μl. The total mortality rate was 15.9%(10/63). Among the 63 patients, 10 cases were in the death group with a median survival time of 5 d, and 53 cases were in the discharge group. The analysis results showed that the incidence of low CD4~+T lymphocyte count, cryptococcal bacteremia, intracranial hypertension, elevated white blood cell count and decreased platelet count in the death group was higher than that in the normal discharge group(P <0.05). The occurrence rates of meningeal irritation singns, cranial nerve involvement, and consciousness disorders were higher in the death group than that in the discharge group(P <0.05). Conclusion The mortality rate of AIDS patients with CM is relatively higher. Strengthen education and cryptococcal screening for high-risk groups to maintain good compliance, detect drug resistance in time, avoid self-discontinuation of drugs,and facilitate early diagnosis and early intervention.更多还原