摘要
Background:Diabetes is a risk factor for acquisition of cryptococcal meningitis(CM).However,the effects of diabetes on outcomes of CM patient have not been fully studied.Methods:In this retrospective study,49 diabetic CM patients and 98 non-diabetic CM patients from January 2008 to December 2018 in the First Affiliated Hospital of Zhejiang University were included by propensity score-matched method(1:2).Demographic characteristics,symptoms,and clinical assay parameters between the two groups were compared.Kaplan-Meier analysis and Cox proportional hazards model were used to assess factors associated with 10-week mortality.Results:The mean age of diabetic patients was 58.2±13.8 years;71.4%(35/49)were more than 50 years old and 46.9%were male.No difference in symptoms was found between diabetic and non-diabetic CM patients.The Charlson comorbidity score was higher in the diabetic group(1.9 vs.0.7,P<0.001).CM patients with diabetes had higher white blood cells count(106/L,111.0(18.0–242.5)vs.50.0(10.0–140.0),P=0.034)in cerebrospinal fluid(CSF),lower CSF India ink positivity(40.8%vs.60.2%,P=0.039),and Cryptococcus culture positivity(42.9%vs.60.2%,P=0.047).The overall 10-week survival rate was 79.7%in diabetic patients vs.83.2%in non-diabetic patients(log-rank P=0.794).Conclusion:Diabetic CM patients have higher CSF glucose and Charlson comorbidity score,but lower CSF India ink and culture positivity than non-diabetic CM patients.No difference in 10-week mortality was found between patients with and without diabetes.Other comorbidities may have a greater effect on prognosis.
基金
This work was supported by the National Science and Technology Major Project of China during the 13th Five-year plan period(2018ZX10302104)
Independent Research Foundation of the State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,the First Affiliated Hospital,School of Medicine,Zhejiang University(2020ZZ19).
