Prognostic markers in AIDS-related cryptococcal meningitis.
Prognostic markers in AIDS-related cryptococcal meningitis.
复制标题
艾滋病相关隐球菌性脑膜炎的预后标志物。
DOI：
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
D. Bandyopadhyay
中科院分区：
文献类型：
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作者：
Shounak Majumder;S. Mandal;D. Bandyopadhyay
客观的
尽管抗逆转录病毒治疗的出现和使用范围不断扩大，但艾滋病毒相关隐球菌性脑膜炎 (CM) 仍然是资源有限环境中感染这种感染者死亡和发病的一个重要原因。
方法
我们对我们中心诊断为隐球菌性脑膜炎的 30 名 HIV 患者进行了为期 6 个月的临床、生化和真菌学参数前瞻性研究，旨在确定预测不良结果的预后因素。
结果
我们的研究记录死亡率为 36.7%。年龄、性别和既往艾滋病毒诊断对患者的生存结果没有影响。该研究发现了一些不良预后因素，包括 GCS 评分低、视乳头水肿、脑脊液开放压升高（>250 mm H2O）以及先前诊断出 HIV 的患者缺乏定期 HIV 护理。死亡率组的脑脊液细胞增多症显着较高。
结论
关注亚洲患者与艾滋病相关的隐球菌性脑膜炎相关的不良预后标志物的尝试相对较少。我们的研究强调了检眼镜和脑脊液测压等简单的床边临床工具如何帮助对这组患者进行风险分层。
OBJECTIVE
Despite the advent and expanding access to antiretroviral therapy, HIV-associated cryptococcal meningitis (CM) remains a significant cause of mortality and morbidity amongst individuals with this infection in resource-limited settings.
METHODS
We prospectively studied the clinical, biochemical and mycological parameters of 30 HIV patients diagnosed with cryptococcal meningitis at our centre over a period of 6 months with a view to identify prognostic factors predictive of poor outcome.
RESULTS
Our study documented a mortality rate of 36.7%. Age, sex and previous diagnosis of HIV had no bearing on the survival outcome of patients. The study identified several poor prognostic factors including low GCS score, papilledema, elevated CSF opening pressure (>250 mm of H2O) and lack of regular HIV care in those with a prior diagnosis of HIV. CSF pleocytosis was significantly higher in the mortality group.
CONCLUSION
There have been relatively few attempts to focus on poor prognostic markers associated with AIDS related Cryptococcal meningitis in Asian patients. Our study highlights how simple bedside clinical tools like ophthalmoscopy and CSF manometry can help in risk stratification in this group of patients.