艾滋病合并新型隐球菌脑膜炎患者实验室检查分析

Comparative analysis of laboratory indexes of patients with AIDS complicated with cryptococcal meningitis

目的 为艾滋病(Acquired Immunodeficiency Syndrome,AIDS)患者临床早期发现诊断新型隐球菌脑膜炎(Cryptococcal Meningitis,CM)提供依据,探讨AIDS合并CM患者与AIDS非神经系统感染/病变患者之间实验室检查指标的差异,及其临床意义。方法 回顾性分析医院2013-2018年收治的AIDS患者的临床资料,将AIDS合并CM患者45例作为研究组,以同期收治的AIDS非神经系统感染/病变患者40例作为对照组,分析两组患者各项实验室指标。结果 组间对照分析结果显示住院天数、脑脊液压力、脑脊液总细胞、脑脊液白细胞、脑脊液总蛋白、脑脊液葡萄糖(GLU)、脑脊液氯化物、红细胞、血红蛋白、血沉、降钙素原、血氯、谷草转氨酶、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)等15项指标差异有统计学意义(P<0.05);差异指标纳入Logistic回归分析,结果显示脑脊液压力、脑脊液GLU、血LDH等3项指标差异有统计学意义(P<0.05),OR值分别为1.027、0.093、0.991。结论 AIDS合并CM患者脑脊液压力高于AIDS非神经系统感染/病变患者,而脑脊液GLU、血LDH低于AIDS非神经系统感染/病变患者。CM相对其他AIDS指征性疾病,炎性渗出和组织器官损伤较轻,血LDH、α-HBDH较低。

OBJECTIVE To provide more clues for the early clinical detection and diagnosis of Cryptococcus neoformans meningitis(CM)in AIDS patients,this study explored the possible clinical significance of differences of laboratory indicators in patients with AIDS complicated with CM and patients with AIDS non-neurological infection/lesion.METHODS Retrospective analysis was performed on the clinical data of AIDS patients admitted to Beijing Ditan hospital Affiliated to Capital Medical University from 2013 to 2018.45 patients with AIDS complicated with CM were selected as the study group,and 40 patients with AIDS non-neurological infection/lesion admitted during the same period were selected as the control group.Statistical analysis was performed on various laboratory indicators.RESULTS The results of intergroup control analysis showed significant differences in 15 indicators including the number of days in hospital,cerebrospinal fluid(CSF)pressure,CSF total cells,CSF white blood cells,proteins of CSF,CSF glucose(GLU),CSF chloride,red blood cells,hemoglobin,erythrocyte sedimentation rate,procalcitonin,blood chlorine,aspertate aminotransferase,lactate dehydrogenase(LDH)and alpha hydroxy butyric acid dehydrogenase(α-HBDH)(P<0.05).The indexes with difference were included in Logistic regression analysis,and the results showed that the differences in three indexes including CSF pressure,CSF glucose and blood LDH were significant(P<0.05),and the OR values were 1.027,0.093 and 0.991,respectively.CONCLUSION The CSF pressure of patients with AIDS complicated with CM was higher than that of patients with AIDS non-neurological infection/lesion,while the CSF glucose and blood LDH were lower than those of patients with AIDS non-neurological infection/lesion.Considering that CM had less inflammatory exudation and tissue and organ damage than other AIDS indicative diseases,it may lead to the relatively low LDH andα-HBDH in the blood of.