中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2009年
4期
348-351
,共4页
孙岚%黄敏君%安亦军%郭增柱
孫嵐%黃敏君%安亦軍%郭增柱
손람%황민군%안역군%곽증주
肺孢子菌肺炎%艾滋病病毒感染%临床病例%流行病学研究
肺孢子菌肺炎%艾滋病病毒感染%臨床病例%流行病學研究
폐포자균폐염%애자병병독감염%림상병례%류행병학연구
Pneumocystis pneumonia%Human immunodeficiency virus,infection%Clinical patients%Epidemiologic study
目的 了解非HIV感染临床病例肺孢子菌肺炎(PCP)的流行现状.方法 用六亚甲基四胺银(GMs)染色镜检和PCR对851例非HIV感染肺炎患者进行检测,从患者痰液或支气管肺泡灌洗液中查到肺孢子菌包囊或DNA为确诊PCP的依据.结果 851例肺炎患者中,肺孢子菌GMS阳性123例(14.5%),PCR阳性202例(23.7%);有免疫功能低下表现的肺炎患者肺孢子菌检出率最高,GMS和PCR阳性率分别高达28.2%和39.4%;在高龄慢性病患者和无明确免疫受损史、肺感染原因待查患者中亦检出PCP患者,GMS阳性率分别为8.7%和10.9%,PCR阳性率分别为17.5%和19.6%.结论 非HIV感染临床病例发生PCP的风险较高,临床医师应注意鉴别有无PCP的可能.
目的 瞭解非HIV感染臨床病例肺孢子菌肺炎(PCP)的流行現狀.方法 用六亞甲基四胺銀(GMs)染色鏡檢和PCR對851例非HIV感染肺炎患者進行檢測,從患者痰液或支氣管肺泡灌洗液中查到肺孢子菌包囊或DNA為確診PCP的依據.結果 851例肺炎患者中,肺孢子菌GMS暘性123例(14.5%),PCR暘性202例(23.7%);有免疫功能低下錶現的肺炎患者肺孢子菌檢齣率最高,GMS和PCR暘性率分彆高達28.2%和39.4%;在高齡慢性病患者和無明確免疫受損史、肺感染原因待查患者中亦檢齣PCP患者,GMS暘性率分彆為8.7%和10.9%,PCR暘性率分彆為17.5%和19.6%.結論 非HIV感染臨床病例髮生PCP的風險較高,臨床醫師應註意鑒彆有無PCP的可能.
목적 료해비HIV감염림상병례폐포자균폐염(PCP)적류행현상.방법 용륙아갑기사알은(GMs)염색경검화PCR대851례비HIV감염폐염환자진행검측,종환자담액혹지기관폐포관세액중사도폐포자균포낭혹DNA위학진PCP적의거.결과 851례폐염환자중,폐포자균GMS양성123례(14.5%),PCR양성202례(23.7%);유면역공능저하표현적폐염환자폐포자균검출솔최고,GMS화PCR양성솔분별고체28.2%화39.4%;재고령만성병환자화무명학면역수손사、폐감염원인대사환자중역검출PCP환자,GMS양성솔분별위8.7%화10.9%,PCR양성솔분별위17.5%화19.6%.결론 비HIV감염림상병례발생PCP적풍험교고,림상의사응주의감별유무PCP적가능.
Objective To analyze the epidemiologic features of Pneumocystis pcumonia (PCP) among non-HIV infected patients in China. Methods Sputum or bronchoalveolar lavage fluid (BALF) specimens obtained from 851 pneumonia patients without HIV infection from Jan. 2006 to Oct. 2008 were detected, using PCR and Gomori' s methenamine silver (GMS) stain for Pneumocystis jirovecii. Results Of the 615 sputum specimens, P.jirovecii positive rates of PCR and GMS stain were 20.3% and 10.2% respectively (P<0.05). Of 236 BALF specimens, P. jirovecii positive rates of PCR and GMS stain were 32.6% and 25.5% respectively (P0.05). Of the total 851 pneumonia cases, 123 (14.5%) were GMS positive for P.jirovecii cyst and 202 cases (23.7%) were PCR positive for P. jirovecii DNA. In those immuno-suppressed patient group including patients with connective tissue diseases, organ transplant recipients, nephrotic, hematologic diseases and malignant tumor, P. jirovecii positive rate appeared the highest, 28.2% for GMS stain and 39.4% for PCR. There were also PCP patients in the immuno-competcnt pneumonia patient groups including senile patients with chronic diseases and patients without clear predisposing immuno-deficiencies. The positive rates of P. jiroveeii GMS were 8.7% and 10.9% , respectively and 17.5% and 19.6% for P. jiroveeii under PCR.Conclusion PCR assay seemed sensitive for the detection of P. jirovecii in the sputum specimens and could be used for screening PCP patients without HIV infection. Our data showed that there was high risk of PCP in non-HIV infected patients in China.
