克林霉素聯(lián)合復(fù)方磺胺甲惡唑治療艾滋病弓形蟲腦病的MRI動態(tài)變化研究
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中圖分類號：R978 文獻標志碼：A 文章編號：1001-8751（2025）02-0073-05
A Study of MRI Dynamics in the Treatment of AIDS Toxoplasmosis Encephalopathy with Clindamycin Combined with Compound Sulfamethoxazole
MengLing-bin， Jiang Min， Wang Yin （Public Health Clinical Center of Chengdu， Chengdu ）
Abstract： ObjectiveIn order to treat toxoplasmosis encephalopathy associated with AIDS， clindamycin in combination with compound sulfamethoxazole is being studied for its effects on MRI imaging.Aditionally， the imaging use of MRI is being investigated.MethodsThirty-one patients with AIDS-related toxoplasmosis encephalopathy admitted to Chengdu Public Health Clinical Medical Center from 2O20 to 2023 were selected to record the pre- and post-treatment MRI imaging changes.ResultsPrior to treatment， 80.65% （25/31） of the patients were multiple， 19.35% （6/31） of the patients were single， and 58.06% （18/31） of the patients were single or combined in the basal ganglia region.After 30 days of treatment， 67.74% （21/31） of the patients showed a significant reduction in the lesions and edema， 70.59% （12/17） of the patients'lesions stabilized after three months，and 94.12% （16/17） of the patients Would stillhave FLAIR high signal foci after three or more months.ConclusionPatients with AIDSrelated toxoplasmosis encephalopathy have characteristic MRI manifestations，significant changes in imaging before and after anti-Toxoplasma gondiitreatment，most patients willhave varying degrees of residual lesions，MRI has important value in clinical diagnosis and treatment， intuitive dynamic effcacy evaluation，and later follow-up.
Key words： clindamycin； sulfamethoxazole； AIDS； MRI； toxoplasmic encephalopathy
弓形蟲為機會性致病原蟲，弓形蟲腦病是一種人畜共患疾病，在免疫功能正常人群中僅潛伏存在，但在艾滋病（Acquired immune deficiencysyndrome，AIDS）等免疫功能低下人群中，弓形蟲感染可引起明顯感染癥狀，嚴重者可導(dǎo)致死亡，神經(jīng)系統(tǒng)是弓形蟲的主要靶器官，在顱內(nèi)形成弓形蟲腦炎[1-2]，艾滋病患者中 5%～40% 有弓形蟲感染[3]，臨床表現(xiàn)復(fù)雜，如發(fā)熱、頭痛、意識障礙和顱神經(jīng)損害等[4]，不易與結(jié)核、腫瘤轉(zhuǎn)移等其他顱內(nèi)病變鑒別[5]，目前診斷手段主要為特異性抗原、抗體檢測及腦脊液聚合酶連反應(yīng)（Polymerasechainreaction，PCR）檢測，這些檢測存在著假陰性或特異性高，敏感性低等問題，確診需要活檢，但有創(chuàng)，磁共振成像（Magneticresonance imaging，MRI）作為主要檢查手段在該病的診斷及治療后評價中起到不可替代的作用。（剩余6551字）