中文摘要：

目的 分析影响艾滋病合并隐球菌脑膜炎（隐脑）的预后因素。方法 收集106例艾滋病合并隐脑的病例资料并随访1年,分析影响其病死率的危险因素。结果 1年归因死亡率24.2%。单因素分析提示与1年归因病死率增多相关因素有神志改变、血液/骨髓隐球菌培养阳性以及肺泡灌洗液隐球菌培养阳性。与归因病死率减少相关的因素有治疗方案含有两性霉素B、累计两性霉素B剂量〉500 mg及两性霉素B剂量〉1 000 mg。Cox风险模型多因素分析提示与1年归因病死独立相关因素包括神志改变、血液/骨髓隐球菌培养阳性、肺泡灌洗液隐球菌培养阳性以及治疗方案两性霉素B剂量〈500 mg。结论 艾滋病合并隐脑患者发生神志改变、血液/骨髓隐球菌培养阳性、肺泡灌洗液隐球菌培养阳性者预后不良,累计两性霉素B剂量〉500 mg才可能改善预后。

英文摘要：

Objective To analyze the prognostic factors of cryptococcal meningitis with AIDS. Methods 106 cases of cryptococcal meningitis with AIDS were collected and followed up for 1 year. Results The 1 - year attributable mortality was 24.2%. Log - rank analysis showed that altered mental status, the positive rate of cryptococcus neoformans in blood/ bone marrowand and in alveolar lavage fluid were factors associated with increased mortality; Factors associated with reduced mortality were amphoteriein B based treatment,amphotericin B cumulative doses greater than 500 mg and 1 000 mg. Cox mul- tivariate analysis showed that independent factors associated with 1 year attributable mortality included altered mental status, the positive rate of cryptococcus neoforrnans in blood / bone marrowand and in alveolar lavage fluid, and the cumulative doses of amphotericin B less than 500 rag. Conclusion A variety of factors were associated with mortality in cryptococcal meningi- tis with AIDS. The cumulative dose of amphotericin B was greater than 500 mg might improve the prognosis.