Analyzsis Of Clinical Features And The Factors Involved In The Curative Effect Of Cryptococcal Meningitis

【Objective】To analyze the factors involved in the curative effect of cryptococcal meningitis.【Methods】52 patients with CM diagnosed according to the positive result of aetiological examination were collected from The First Affiliated Hospital of Fujian Medical University from June 2002 to June.2009. The 52 cases were divided into two groups, namely, improved group and not improved group, according to their improvement of the clinical manifestation , physical examination findings ,as well as the reduction of CSF cryptococus colony forming units(CFU). The clinical manifestation, laboratory data and therapies were collected as study objects, and the relationship between these objects and the curative effect were accessed with chi square test and multiple logistic regression analysis.【Results】There was no significant difference in outcome among three difference antifungal treatments,which are the AmB+5-FC, FCZ+5-FC and AmB+5-FC+FCZ (P>0.05),but the therapy of FCZ combined with 5-FC is less toxic.The CSF cryptococus CFU(P=0.001), the course of therapy(P=0.000), the dose of Amphotericin B(P=0.036), interventional procedures (P=0.036) and the outcome of 2-week antifungal therapy (P=0.016) represent association with curative effect. Mutiple logistic regression analysis showed that none factor was strongly enough associated with curative effect.【Conclusion】The therapy of FCZ combined with 5-FC is less toxic than the other treatments. The result suggests that patients with the CSF cryptococus CFU>100×106/L, shorten course of therapy , insufficient dose of Amphotericin B, elevated intracranial pressures and failure in a 2-week antifungal therapy tend to have a poor prognosis.