克林霉素联合复方磺胺甲恶唑治疗艾滋病弓形虫脑病的MRI动态变化研究

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中图分类号：R978 文献标志码：A 文章编号：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

弓形虫为机会性致病原虫，弓形虫脑病是一种人畜共患疾病，在免疫功能正常人群中仅潜伏存在，但在艾滋病（Acquired immune deficiencysyndrome，AIDS）等免疫功能低下人群中，弓形虫感染可引起明显感染症状，严重者可导致死亡，神经系统是弓形虫的主要靶器官，在颅内形成弓形虫脑炎[1-2]，艾滋病患者中 5%～40% 有弓形虫感染[3]，临床表现复杂，如发热、头痛、意识障碍和颅神经损害等[4]，不易与结核、肿瘤转移等其他颅内病变鉴别[5]，目前诊断手段主要为特异性抗原、抗体检测及脑脊液聚合酶连反应（Polymerasechainreaction，PCR）检测，这些检测存在着假阴性或特异性高，敏感性低等问题，确诊需要活检，但有创，磁共振成像（Magneticresonance imaging，MRI）作为主要检查手段在该病的诊断及治疗后评价中起到不可替代的作用。（剩余6551字）