中文摘要：

目的分析非艾滋病患者隐球菌脑膜炎治疗与随访过程中真菌学指标变化规律，以指导临床治疗。方法回顾性分析28例资料完整的非艾滋病患者隐球菌脑膜炎治疗与随访过程中的脑脊液真菌涂片，进行菌体计数、真菌培养和乳胶凝集试验。给予两性霉素B静脉滴注，联合口服氟胞嘧啶或氟康唑，疗程≥6周作为初期治疗，后给予氟康唑或（和）伊曲康唑口服≥2个月作为维持治疗，28例患者均完全治愈。统计学处理采用秩和检验。结果治疗前脑脊液真菌涂片阳性率为92．9％，随着治疗的进行，真菌涂片的阳性率逐渐降低，菌体计数明显减少，但初期治疗结束后仍有患者真菌涂片结果为阳性。真菌培养生长所需时间逐渐延长，所有患者在治疗开始后2周真菌培养结果均转为阴性。脑脊液乳胶凝集试验阳性率为100％，治疗和随访过程中滴度不断下降，但与菌体计数降低无明显相关性。结论隐球菌脑膜炎治疗中需要综合评价真菌学指标，对每个指标需进行具体分析。

英文摘要：

Objective To examine mycological profile of cryptococcal meningitis in patients with non-acquired immune deficiency syndrome （AIDS） during treatment and follow-up so that to support clinical therapy. Methods Data of 28 culture-confirmed cryptoeoccal meningitis patients with non- AIDS were retrospectively analyzed. Fungal smear, count, culture and latex agglutination test of cerebrospinal fluid （CSF） were done during treatment and follow-up. Initial treatment included intravenous amphotericin B plus oral flucytosine or fluconazole for at least 6 weeks, and consolidation treatment included oral fluconazole and （or） itraconazole for at least 2 months. All 28 patients were cured. The data were analyzed by rank-sum test. Results The positive rate of CSF fungal smear was 92.9% before treatment and gradually decreased, and the fungal count was significantly reduced over time after treatment. While fungal smears of some patients were still positive after initial treatment. Fungal growth time in culture was gradually extended, and fungal culture turned to be negative in all patients after 2 weeks of treatment. The positive rate of latex agglutination test of CSF was 100%. Cryptococcal antigen titer decreased steadily after treatment, which was not correlated with the decrease of fungal count. Conclusion Mycological tests of patients with cryptococcal meningitis should be interpreted comprehensively during treatment, and result of each test should be specifically analyzed.