Nielsen C J, Gjerris F, Pedersen H, Jensen F K, Wagn P
University Clinic of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
Acta Neurochir (Wien). 1994;127(1-2):99-102. doi: 10.1007/BF01808555.
Nineteen male patients with AIDS were investigated by biopsy of brain lesions. Six patients had progressive multiple leucoencephalopathy and no specific treatment was given. Toxoplasmosis (two patients), bacterial abscesses (two cases), viral encephalitis (two patients) and only gliosis (two cases) accounted for almost half of the cases. A fungal infection, a lymphoma and a sarcoma-like tumour were found in three patients. In two patients the biopsy was not diagnostic: one had only necrosis and one had normal findings. The biopsy findings gave reason for modifying the treatment in only three cases. The mean survival rate was relatively short, only 76 days with a range from 1 to 1041 days. Two patients were in a very bad clinical condition at the time of biopsy and one died of a haemorrhagic complication due to the biopsy. In ten cases an autopsy was carried out. In five cases there was agreement between the biopsy and autopsy findings. In the other five cases the autopsy findings differed widely. In our experience we can recommend cerebral biopsy in patients with AIDS only after treatment for toxoplasmosis and mainly to estimate the prognosis.
对19例男性艾滋病患者的脑损伤进行了活检调查。6例患有进行性多灶性白质脑病，未给予特殊治疗。弓形虫病（2例）、细菌性脓肿（2例）、病毒性脑炎（2例）以及仅存在胶质增生（2例）几乎占了病例的一半。3例患者发现真菌感染、淋巴瘤和肉瘤样肿瘤。2例活检未得出诊断结果：1例仅有坏死，1例检查结果正常。活检结果仅在3例中为调整治疗提供了依据。平均生存率相对较短，仅76天，范围为1至1041天。2例患者在活检时临床状况极差，1例因活检出现出血并发症死亡。10例进行了尸检。5例活检结果与尸检结果一致。在其他5例中，尸检结果差异很大。根据我们的经验，仅在对弓形虫病进行治疗后，且主要是为了评估预后，我们才建议对艾滋病患者进行脑活检。
