Risk factors and prognosis analysis of cranial nerve injury in non-acquired immune deficiency syndrome-related cryptococcal meningitis
10.3760/cma.j.issn.1673-4904.2014.08.006
- VernacularTitle:非艾滋病相关隐球菌性脑膜炎合并脑神经损伤的危险因素及预后分析
- Author:
Xinlong ZHONG
;
Hailong LUO
- Publication Type:Journal Article
- Keywords:
Meningitis,cryptococcal;
Cranial nerve injuries;
Amphotericin B;
Triazoles;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(8):17-20
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk and prognosis factor of cranial nerve injury in non acquired immune deficiency syndrome(AIDS)-related cryptococcal meningitis.Methods The clinical data of 115 patients with non-AIDS-related cryptococcal meningitis were reviewed retrospectively.Clinical characteristics,initial antifungal therapies and outcome of these patients were analyzed.The risk and prognosis factor was performed by multivariate Logistic regression.Results The incidence of cranial nerve injury was 35.7％(41/115).Among of them,the involved ratio was 48.8％ (20/41),39.0％ (16/41),24.4％ (10/41),12.2％ (5/41),7.3％ (3/41),4.9％ (2/41) in optic nerve,oculomotor nerve,acoustic nerve,abducent nerve,olfactory nerve,facial nerve.Predictive risk factor for cranial nerve injury was duration of diagnosis (OR =1.057,95％ CI 1.003-1.112),low cerebrospinal fluid cell count and intracranial hypertension were also the independent predictive factors (both P ＜ 0.05).In the follow-up peried,72.2％ (26/36) patients who had cranial nerve injury were fully recovered,with a median time of 0.5-24.0 (3.8 ±1.7) months.The independent predictors of recovery were numbers of nerve involved (OR =0.241,95 ％ CI 0.067-0.801,P =0.023) and combination therapy (OR =10.328,95 ％ CI 2.087-51.026,P =0.006).Condusions Cranial nerve injury is common in non-AIDS-related cryptococcal meningitis.Delay in diagnosis,intracranial hypertension and low cerebrospinal fluid cell count are independent predictive factors.Less cranial nerve involvement and combination therapy predicts recovery.
