DeCarli C, Fugate L, Falloon J, Eddy J, Katz D A, Friedland R P, Rapoport S I, Brouwers P, Pizzo P A
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892.
J Acquir Immune Defic Syndr (1988). 1991;4(6):585-92.
The ventricular area at the level of the foramen of Monro was measured from axial x-ray computed tomography (CT) scans obtained prior to and 6 months after the initiation of continuous infusion of zidovudine (ZDV) in eight children with human immunodeficiency virus-induced encephalopathy. Evidence of moderate to severe central atrophy was present on initial CT scans (p less than 0.05). Ventricular area and ventricular brain area ratio (VBR) decreased after ZDV therapy in seven of eight children (mean decrease of 21.5 and 20%, respectively, p less than 0.05). The degree of decrease in VBR correlated with reductions in cerebrospinal fluid (CSF) protein concentration (r = 0.93, p less than 0.01), but not lymphocyte T4 or T8 counts. Intelligence quotients (IQs) improved in all seven children tested (mean improvement of 17.7%, p less than 0.01) and correlated significantly with reductions in CSF protein concentration (r = -0.85, p = 0.003). The magnitude of IQ changes was not significantly correlated with the magnitude of changes in ventricular area. We conclude that the cognitive improvement of HIV encephalopathy seen after 6 months of continuous infusion of ZDV is accompanied by reduction in brain atrophy and decreased CSF protein, suggesting an ameliorating effect of ZDV on the pathogenesis of AIDS encephalopathy in children.
在8例人类免疫缺陷病毒所致脑病患儿中，于持续输注齐多夫定（ZDV）前及开始输注6个月后，通过轴向X线计算机断层扫描（CT）测量了Monro孔水平的脑室面积。初始CT扫描显示存在中度至重度脑萎缩（p<0.05）。8例患儿中有7例在接受ZDV治疗后脑室面积和脑室脑面积比（VBR）下降（平均分别下降21.5%和20%，p<0.05）。VBR的下降程度与脑脊液（CSF）蛋白浓度的降低相关（r = 0.93，p<0.01），但与淋巴细胞T4或T8计数无关。所有7例接受测试的患儿智商（IQ）均有所提高（平均提高17.7%，p<0.01），且与CSF蛋白浓度的降低显著相关（r = -0.85，p = 0.003）。IQ变化的幅度与脑室面积变化的幅度无显著相关性。我们得出结论，持续输注ZDV 6个月后所见的HIV脑病认知改善伴随着脑萎缩减轻和CSF蛋白降低，提示ZDV对儿童艾滋病脑病发病机制有改善作用。
