血浆(1-3)-β-D葡聚糖对AIDS合并CM预后评估价值研究

doi:10.3969/j.issn.1006-6233.2021.08.029

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Abstract Objective: To study the value of plasma (1-3)-β-D glucan in evaluating the prognosis of acquired immune deficiency syndrome (AIDS) complicated with Cryptococcal meningitis (CM). Methods: The clinical data of 66 AIDS patients complicated with CM from January 1, 2015 to December 31, 2020 were analyzed retrospectively, and they were divided into survival group (56 cases) and death group (10 cases) according to their living conditions within one year. We collected the gender, age, route of transmission, clinical symptoms (headache, fever, vomiting and disturbance of consciousness), head imaging examination, laboratory examination at admission (CD4⁺T lymphocyte count, plasma HIV-RNA viral load, peripheral blood hemoglobin, peripheral white blood cell count, peripheral blood neutrophil count, C-reactive protein, ESR, procalcitonin, cerebrospinal fluid glucose, cerebrospinal fluid chloride and cerebrospinal fluid protein, cerebrospinal fluid culture, cerebrospinal fluid smear, culture of Cryptococcus in blood, plasma (1-3)-β-D glucan concentration) and the first plasma (1-3)-β after antifungal treatment. Multivariate Logistic regression analysis of death risk factors in AIDS patients complicated with CM. The value of receiver operating characteristic curve ROC in predicting the death of AIDS patients complicated with CM by analyzing plasma (1-3)-β-D glucan. Results: Univariate analysis showed that PCT, CD4⁺ lymphocyte and plasma (1-3)-β-D glucan concentration were the risk factors for death of AIDS patients with CM (P<0.05). Multivariate Logistic regression analysis showed that high concentration of plasma (1-3)-β-D glucan is an independent risk factor for death in patients with AIDS complicated with CM (P<0.05). ROC curve analysis showed that the area under the curve was the largest (0.787, 95%CI 0.665～0.910). when plasma (1-3)-β-d glucan was 65.63pg/ml before antifungal treatment, and its sensitivity and specificity were higher (90.0% and 76.8%, respectively) (P<0.05). Conclusion: Plasma (1-3) -β-D-glucan has a high value in evaluating the prognosis of patients with AIDS complicated with CM, and plasma (1-3) -β-D-glucan > 65.63pg/ml indicates a high risk of death.

Key words： AIDS Cryptococcal meningitis Plasma (1-3)-β-D glucan Prognostic

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.08.029 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I8/1367

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