r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2023-28-2-25-30r-n-j-410Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSПоказатели клинического статуса и нейронспецифической енолазы в ликворе у пациентов с церебральным токсоплазмозом при ВИЧ-инфекции в стадии СПИДClinical manifestations and neuron-specific enolase cerebrospinal fluid concentration in HIV/AIDS patients with cerebral toxoplasmosishttps://orcid.org/0000-0001-5088-2855СексяевН. Е.SeksyaevN. E.

Сексяев Никита Евгеньевич

Пермь

Perm

snevrolog@gmail.comhttps://orcid.org/0000-0002-7536-2060КаракуловаЮ. В.KarakulovaYu. V.

Пермь

Perm

julia.karakulova@mail.ruhttps://orcid.org/0000-0002-1232-8826СоснинД. Ю.SosninD. Yu.

Пермь

Perm

sosnin_dm@mail.ruФГБОУ ВО «Пермский государственный медицинский университет им. академика Е.А. Вагнера»РоссияPerm State Medical University named after Academician E.A. WagnerRussian Federation2023180520232822530Copyright © Сексяев Н.Е., Каракулова Ю.В., Соснин Д.Ю., 20232023Сексяев Н.Е., Каракулова Ю.В., Соснин Д.Ю.Seksyaev N.E., Karakulova Y.V., Sosnin D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/410

Церебральный токсоплазмоз (ЦТ) является одной из основных причин развития очагового неврологического дефицита у пациентов с ВИЧ-инфекцией в стадии СПИД. Своевременная диагностика ЦТ и назначение противопаразитарной терапии способствуют снижению летальности и инвалидизации.

Цель исследования

Цель исследования. Изучить неврологический статус и концентрацию нейронспецифической енолазы (НСЕ) в ликворе у пациентов с церебральным токсоплазмозом на фоне ВИЧ-инфекции в стадии СПИД, динамике до и после курса противопаразитарной терапии.

Материал и методы

Материал и методы. Исследованы 35 пациентов, 10 женщин и 25 мужчин в возрасте от 28 до 50 лет. Проведено проспективное когортное исследование неврологического статуса с оценкой когнитивных функций и ликворологических показателей при ЦТ до и во время терапии с контрольными точками на 1-й и 10-й день наблюдения.

Результаты

Результаты. Разработана и применена методика количественной оценки тяжести неврологического дефицита при ЦТ. Определена связь выраженности двигательного, сенсорного дефицита и когнитивной дисфункции с изменением концентрации НСЕ в ликворе, которые являются показателями активности энцефалитического процесса.

Заключение

Заключение. Мониторинг изменения концентрации НСЕ в ликворе в сочетании с динамической оценкой тяжести неврологического дефицита может быть использован в качестве подтверждения эффективности специфической противопаразитарной терапии у пациентов с ВИЧ-инфекцией в стадии СПИД.

Background

Background. Cerebral toxoplasmosis (CT) is one of the most common cause of focal neurological defi cit in HIV/ AIDS group of patients. Timely diagnosis of CT and antiparasitic therapy contribute to decrease of lethal outcomes and disability.

Aim

Aim. To study neurological manifestations, cognitive functions and neuron-specifi c enolase (NSE) concentration in cerebrospinal fluid (CSF), in HIV/AIDS patients with CT.

Material and methods

Material and methods. The 35 patients (10 females and 25 males) from 28 to 50 years old with confirmed diagnosis of HIV/AIDS-associated CT were included in the investigation group. Neurological status, cognitive function and laboratory CSF changings had been studied in prospective investigation before and during the treatment with control points in the 1st and 10th days of the observation.

Results

Results. The method of neurological manifestation of CT evaluation had been developed and implemented in practice. The association between neurological defi cit severity (movement and sensory disorders), cognitive decline and increasing CSF concentration of NSE in HIV/AIDS-associated CT was determined that demonstrates the activity of encephalitic process.

Conclusion

Conclusion. Dynamic evaluation of NSE concentration in CSF with clinical assessment of neurological manifestation in patients with HIV/AIDS-associated CT may be used for confirmation of specific antiparasitic treatment effectiveness and for increasing clinical criteria significance.

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The authors declare that there are no conflicts of interest present.