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隐球菌性脑膜炎患者中枢和外周代谢特征的回顾性分析

A Retrospective Analysis of Central and Peripheral Metabolic Characteristics in Patients with Cryptococcal Meningitis.

作者信息

Qin Jianglong, Nong Lanwei, Zhu Qingdong, Huang Zhizhong, Wu Fengyao, Li Sijun

机构信息

The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China.

出版信息

Neurol Ther. 2024 Jun;13(3):763-784. doi: 10.1007/s40120-024-00610-z. Epub 2024 Apr 20.

Abstract

INTRODUCTION

Most current treatment strategies and investigations on cryptococcal meningitis (CM) focus primarily on the central nervous system (CNS), often overlooking the complex interplay between the CNS and the peripheral system. This study aims to explore the characteristics of central and peripheral metabolism in patients with CM.

METHODS

Patients diagnosed with CM as per the hospital records of the Fourth People's Hospital of Nanning were retrospectively analyzed. Patients were divided into two groups, non-structural damage of the brain (NSDB) and structural damage of the brain (SDB), according to the presence of brain lesions as detected with imaging. Based on the presence of enlarged cerebral ventricles, the cases in the SDB group were classified into non-ventriculomegaly (NVM) and ventriculomegaly (VM). Various parameters of cerebrospinal fluid (CSF) and peripheral blood (PB) were analyzed.

RESULTS

A significant correlation was detected between CSF and PB parameters. The levels of CSF-adenosine dehydrogenase (ADA), CSF-protein, CSF-glucose, and CSF-chloride ions were significantly correlated with the levels of PB-aminotransferase, PB-bilirubin, PB-creatinine (Cr), PB-urea nitrogen, PB-electrolyte, PB-protein, and PB-lipid. Compared with NSDB, the levels of CSF-glucose were significantly decreased in the SDB group, while the levels of CSF-lactate dehydrogenase (LDH) and CSF-protein were significantly increased in the SDB group. In the SDB group, the levels of PB-potassium, PB-hemoglobin(Hb), and PB-albumin were significantly decreased in the patients with VM, while the level of PB-urea nitrogen was significantly increased in these patients.

CONCLUSION

Metabolic and structural alterations in the brain may be associated with peripheral metabolic changes.

摘要

引言

目前大多数关于隐球菌性脑膜炎(CM)的治疗策略和研究主要集中在中枢神经系统(CNS),常常忽视了中枢神经系统与外周系统之间复杂的相互作用。本研究旨在探讨CM患者中枢和外周代谢的特征。

方法

回顾性分析南宁市第四人民医院病历中诊断为CM的患者。根据影像学检查发现的脑损伤情况,将患者分为两组,即脑非结构性损伤(NSDB)组和脑结构性损伤(SDB)组。根据脑室扩大情况,将SDB组病例分为非脑室扩大(NVM)和脑室扩大(VM)。分析脑脊液(CSF)和外周血(PB)的各项参数。

结果

检测到CSF和PB参数之间存在显著相关性。CSF-腺苷脱氢酶(ADA)、CSF-蛋白、CSF-葡萄糖和CSF-氯离子水平与PB-转氨酶、PB-胆红素、PB-肌酐(Cr)、PB-尿素氮、PB-电解质、PB-蛋白和PB-脂质水平显著相关。与NSDB组相比,SDB组CSF-葡萄糖水平显著降低,而SDB组CSF-乳酸脱氢酶(LDH)和CSF-蛋白水平显著升高。在SDB组中,VM患者的PB-钾、PB-血红蛋白(Hb)和PB-白蛋白水平显著降低,而这些患者的PB-尿素氮水平显著升高。

结论

脑内的代谢和结构改变可能与外周代谢变化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26e3/11136911/d8f13b7a80bd/40120_2024_610_Fig1_HTML.jpg

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