隐球菌脑膜炎患者治疗后隐球菌超微结构观察

目的研究隐球菌脑膜炎治疗后菌体超微结构的变化，探讨电镜检查在隐球菌活力检测中的应用。方法对8例经过两性霉素B和5-氟胞嘧啶联合治疗8周后，脑脊液中仍然可以查见隐球菌的患者，采用透射电镜对其脑脊液中的隐球菌进行超微结构观察。结果隐球菌菌体结构都显示了明显的变异：菌体大小差异显著，菌体形态变化明显；荚膜结构紊乱，菌体内可见空洞状或多个巨大脂滴，部分菌体胞膜破损，胞浆溢出。结论隐球菌脑膜炎治疗后虽然脑脊液中还存在菌体，但是菌体的超微结构已经发生了重大变化，提示菌体活力降低或死亡。电镜检查可以作为隐球菌活力判定的一种有效手段，提高隐球菌脑膜炎疗效判定的准确性。

Ultrastructure of cryptococcus from patients with cryptococcal meningitis after treatment

Objective To investigate the ultrastructure of cryptococcus from patients with cryptococcal meningitis after treatment and discuss the viability of cryptococcus.Methods Cerebrospinal fluid from 8 patients, who were treated with amphotericin B plus 5-fucytosin for 8 weeks and still showed positive result of CSF microscopy test, were tested by electron microscopy to detect the ultrastructure of cryptococccus cells.Result Capsule,cell size, membrane and structure of cryptococcus cells under electron microscopy changed significantly after treatment of cryptococcal meningitis, including: different size and metamorphosis of cell and capsule size, disarangement of capsule, hole of membrane, large fat-drop or hole in the cells.Conlusions Ultrastructure of cryptococus cell changed remarkably after treatment which indicated that decrease of the viability or death of cryptococcus cells. Electron microscopy should be an effective method to detect the viability of cryptococcus and assess effect of treatment.