摘要
目的 探究伴发病对隐球菌性脑膜炎患者临床治疗效果的影响。方法 采用回顾性病例对照研究方法将327例非HIV非器官移植的患者基于入院时是否存在伴发病分为研究组(隐脑+伴发病172例)和对照组(隐脑无伴发病155例),并对两组患者的基本临床资料(性别、年龄、入院后首次脑脊液特征等)和临床治疗效果进行比较,分析伴发病的数量及种类对隐脑+伴发病组患者临床治疗效果的影响。结果 研究组脑脊液白细胞计数、蛋白、糖和氯化物含量与对照组比较差异均有统计学意义(P<0.05);在进行10周的抗真菌治疗后,对照组患者治疗疗效优于研究组,差异有统计学意义(Z=-2.131,P=0.033);研究组中临床治疗成功与治疗失败患者在伴发病数量上的差异没有统计学意义;伴有消化系统和内分泌系统疾病的患者,治疗失败的人数更多,差异有统计学意义(P<0.05)。结论 入院时有伴发病的隐球菌性脑膜炎患者的治疗失败率更高,不良的预后结果与入院时伴发病数量无关,而与合并消化系统和内分泌系统疾病有关。
OBJECTIVE To explore the influence of underlying diseases on clinical treatment of patients with cryptococcal meningitis.METHODS A total of 327HIV-negative patients without organ transplantation were retrospectively analyzed;according to the fact whether the patients had underlying diseases,172patients who had cryptococcal meningitis plus underlying diseases were assigned as the study group,and 155cryptococcal meningitis patients who did not have underlying diseases were set as the control group.The baseline clinical data,including gender, age,initial features of cerebrospinal fluid after admission,as well as the clinical curative effect,were observed and compared between the two groups of patients.The influence of the number and types of underlying diseases on the clinical curative effect of the cryptococcal meningitis patients with underlying diseases was observed. RESULTS There were significant differences in the cerebrospinal fluid white blood cells counts,protein,glucose and chlorides contents between the study group and the control group(P<0.05).The curative effect of the study group was significantly better than that of the control group after the antifungal therapy for 10weeks(Z=-2.131, P=0.033).There was no significant difference in the number of the underlying diseases between the patients who were successful for the clinical treatment and the patients who failed.The patients complicated with digestive system and endocrine system diseases who failed the treatment were significantly more than those with other underlying diseases(P<0.05).CONCLUSIONThe rate of failed treatment is higher among the cryptococcal meningitis patients who have underlying diseases at admission,the adverse treatment outcomes are not associated with the number of underlying diseases at admission but are associated with the digestive system and endocrine system diseases.
作者
徐莉
陈灼林
刘佳
李敏
朱灿胜
易寰
彭福华
XU Li;CHEN Zhuo-lin;LIU Jia;LI Min;ZHU Can-sheng;YI Huan;PENG Fu-hua(The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong510630,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第2期229-232,24,共5页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81271327)
广东省自然科学基金资助项目(2015A03013167)
关键词
伴发病
隐球菌性脑膜炎
治疗效果
Underlying disease
Cryptococcal meningitis
Treatment outcome
