新型隐球菌性脑膜炎患者脑脊液中隐球菌及CD4+ T细胞关系研究.docVIP

新型隐球菌性脑膜炎患者脑脊液中隐球菌及CD4+ T细胞关系研究[摘要] 目的：探讨新型隐球菌性脑膜炎患者的脑脊液特点。方法：腰椎穿刺术获得脑脊液，脑脊液标本涂片墨汁染色查找带有荚膜的新型隐球菌。采用免疫细胞化学染色方法观察隐球菌数量与白细胞计数及CD4+ T细胞计数的关系。结果：28例新型隐球菌性脑膜炎患者，脑脊液白细胞数在（10~300）×106/L之间，多以淋巴细胞为主。随着疾病病程的进展和治疗，出现隐球菌先增后减与白细胞先减后增的变化趋势，而CD4+ T细胞则随疾病的治疗逐渐减少。结论：脑脊液中CD4+ T细胞可作为新型隐球菌性脑膜炎患者疗效观察的指标。 [关键词] 新型隐球菌性脑膜炎；脑脊液；CD4+ T细胞；免疫细胞化学染色 [中图分类号] R378.1+5 [文献标识码]A[文章编号]1674-4721（2011）08（b）-０11－０2 The relationship between the cryptococcus neoformans and CD4+ T cells in the cerebrospinal fluid of the patients with cryptococcal meningitis ZHANG Qiaoquan1, SHI Jianquan2, WANG Juan1, ZHU Haiqing1, LIN Xingjian2? 1.Department of Pathology, Brain Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Nanjing 210029, China; 2.Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Nanjing 210029, China [Abstract] Objective: To investigate the features of cerebrospinal fluid of the patients with cryptococcal meningitis. Methods: Cerebrospinal fluid of the patients was obtained by spinal puncture. All cerebrospinal fluid specimens were smeared and tested by ink staining to find the cryptococcus neoformans with capsule. The relationship between the cryptococcus neoformans and white blood cells as well as CD4+ T cells was observed by immuncytochemistry. Results: In 28 cases of cryptococcal meningitis patients, the white blood cell counts of the cerebrospinal fluid were about (10-300)×106/L, mostly lymphocytes. With the progression of the disease and treatment, the number of cryptococcus neoformans increased at the early time and then decreased and the number of the white blood cells decreased at the early time and then increased, while CD4+ T cells were gradually reduced as the treatment was administrated. Conclusion: CD4+ T cells in cerebrospinal fluid could be regarded as an indicator of efficiency of treatment of cryptococcal meningitis. [Key words] Cryptococcal meningitis; Cerebrospinal fluid; CD4+ T cells; Immuncy