The Change in the Neutrophil/Lymphocyte Ratio Predicts the Prognosis of Patients with Cryptococcal Meningitis,Mycopathologia

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The Change in the Neutrophil/Lymphocyte Ratio Predicts the Prognosis of Patients with Cryptococcal Meningitis
Mycopathologia ( IF 5.5 ) Pub Date : 2021-08-31 , DOI: 10.1007/s11046-021-00553-1
Keming Zhang _{1,

2} , Hang Li _{1,

2} , Lei Zhang _{1,

2} , Wanqing Liao _{1,

2} , Liangqi Cai ₃ , Xinhua Li ₄ , Weihua Pan _{1,

2} , Qilong Zhang _{5,

6}

Affiliation

Purpose

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied in many diseases. However, their roles in cryptococcal meningitis (CM) are unclear. The purpose of this article was to analyse the roles of the PLR and NLR in CM patients during treatment.

Methods

139 newly diagnosed CM patients were enrolled. We divided patients into two groups: the successful group (n = 121) and the failure group (n = 18) based on the prognosis of patients. Then, we analyzed changes in clinical data of two groups, which were measured at the time of admission, after 2 weeks and 4 weeks in the hospital. Then the patients were divided into HIV group (n = 26) and non-HIV group (n = 113) to determine whether HIV status had an impact on the prognosis and clinical data of patients.

Results

Most patients were male living in rural areas; headache was the most common symptom before admission. In the subgroup analysis based on HIV status, there were significantly fewer patients with HIV (26 individuals) than without HIV (113 individuals), and 40.7% non-HIV CM patients had no underlying diseases. There was no significant difference in prognosis (p = 0.746), lymphocytes (p = 0.109) or neutrophils (p = 0.269) between patients with and without HIV. A mixed-effect model indicated that there was no difference (p = 0.171) in PLR between successful group and failure group. However, the change of NLR was statistically significant (p = 0.004 < 0.05) between successful group and failure group.

Conclusion

An increase in the NLR during treatment may be used as an indicator of treatment failure.

中文翻译：

中性粒细胞/淋巴细胞比率的变化预测隐球菌脑膜炎患者的预后

目的

中性粒细胞与淋巴细胞比率 (NLR) 和血小板与淋巴细胞比率 (PLR) 已在许多疾病中得到研究。然而，它们在隐球菌性脑膜炎 (CM) 中的作用尚不清楚。本文旨在分析 PLR 和 NLR 在 CM 患者治疗过程中的作用。

方法

招募了 139 名新诊断的 CM 患者。我们根据患者的预后将患者分为两组：成功组（n =121）和失败组（n =18）。然后，我们分析了两组在入院时、住院2周和4周后临床资料的变化。然后将患者分为HIV组（n =26）和非HIV组（n =113），以确定HIV状态是否对患者的预后和临床资料产生影响。

结果

大多数患者是居住在农村地区的男性；头痛是入院前最常见的症状。在基于 HIV 状态的亚组分析中，感染 HIV 的患者（26 人）明显少于无 HIV 的患者（113 人），40.7% 的非 HIV CM 患者没有基础疾病。感染和未感染 HIV 的患者在预后 ( p = 0.746)、淋巴细胞 ( p = 0.109) 或中性粒细胞 ( p = 0.269) 方面没有显着差异。混合效应模型表明成功组和失败组的 PLR没有差异 ( p = 0.171)。然而，成功组和失败组之间NLR 的变化具有统计学意义（p = 0.004 < 0.05）。