CAJ | 학술논문

目的了解北京、河南、新疆地区HIV感染者和艾滋病患者(HIV/AIDS)相关慢性腹泻患者中隐孢子虫感染状况。方法收集3个地区HIV/AIDS相关慢性腹泻患者粪便，采用甲醛-乙酸乙酯沉淀法集卵，用改良抗酸染色法染色检测隐孢子虫卵囊。同时检测患者血液CD4+T淋巴细胞计数。结果253例HIV/AIDS相关慢性腹泻患者的粪便标本中有32例为隐孢子虫阳性，感染率为12.6％。北京、河南、新疆地区艾滋病慢性腹泻患者隐孢子虫感染率分别为5.97％(4/67)、16.1％(24/149)和10.8％(4/37)，地区间差异有统计学意义(x2=4.431,P＜0.05)。男性和女性艾滋病慢性腹泻患者隐孢子虫感染率分别为11.2％( 16/1 43)和14.5％(16/110),差异无统计学意义（x2=0.634,P＞0.05）；城市和农村艾滋病慢性腹泻患者隐孢子虫感染率分别为6.5％(7/104)和16.8％(25/149)，差异有统计学意义(x2=5.596,P＜0.05)；夏秋季与其他季节的艾滋病慢性腹泻患者隐孢子虫感染率分别为14.0％(30/214)和5.1％(2/39)，差异无统计学意义(P＞0.05)；艾滋病慢性腹泻患者处于HIV感染无症状期、有症状期、艾滋病期隐孢子虫感染率分别为0％(0/7)、21.3％(19/89)、8.3％( 13/157),差异有统计学意义(x2=9.822，P＜0.01)；不同CD4+T淋巴细胞计数水平（cell/μl）艾滋病慢性腹泻患者隐孢子虫感染率有差异,＜200为20.4％ (20/98),200～499为9.23％(12/130)，≥500为0％( 0/25),差异有统计学意义(x2=10.33,P＜0.01)。艾滋病中晚期慢性腹泻患者，尤其是CD4+T淋巴细胞计数＜200 cell/μl的患者其感染率明显增加。结论3个地区艾滋病慢性腹泻患者隐孢子虫感染率与性别无关；患者来自农村地区、CD4+T淋巴细胞计数水平降低、疾病为中晚期患者易发生隐孢子虫感染。
목적 료해북경、하남、신강지구HIV감염자화애자병환자(HIV/AIDS)상관만성복사환자중은포자충감염상황。방법수집3개지구HIV/AIDS상관만성복사환자분편，채용갑철-을산을지침정법집란，용개량항산염색법염색검측은포자충란낭。동시검측환자혈액CD4+T림파세포계수。결과253례HIV/AIDS상관만성복사환자적분편표본중유32례위은포자충양성，감염솔위12.6％。북경、하남、신강지구애자병만성복사환자은포자충감염솔분별위5.97％(4/67)、16.1％(24/149)화10.8％(4/37)，지구간차이유통계학의의(x2=4.431,P＜0.05)。남성화녀성애자병만성복사환자은포자충감염솔분별위11.2％( 16/1 43)화14.5％(16/110),차이무통계학의의（x2=0.634,P＞0.05）；성시화농촌애자병만성복사환자은포자충감염솔분별위6.5％(7/104)화16.8％(25/149)，차이유통계학의의(x2=5.596,P＜0.05)；하추계여기타계절적애자병만성복사환자은포자충감염솔분별위14.0％(30/214)화5.1％(2/39)，차이무통계학의의(P＞0.05)；애자병만성복사환자처우HIV감염무증상기、유증상기、애자병기은포자충감염솔분별위0％(0/7)、21.3％(19/89)、8.3％( 13/157),차이유통계학의의(x2=9.822，P＜0.01)；불동CD4+T림파세포계수수평（cell/μl）애자병만성복사환자은포자충감염솔유차이,＜200위20.4％ (20/98),200～499위9.23％(12/130)，≥500위0％( 0/25),차이유통계학의의(x2=10.33,P＜0.01)。애자병중만기만성복사환자，우기시CD4+T림파세포계수＜200 cell/μl적환자기감염솔명현증가。결론3개지구애자병만성복사환자은포자충감염솔여성별무관；환자래자농촌지구、CD4+T림파세포계수수평강저、질병위중만기환자역발생은포자충감염。
Objective To investigate the Cryptosporidium infection and its epidemiological characteristics in HIV/AIDS patients with chronic diarrhea. Methods Stool samples collected from HIV/AIDS confirmed patients with chronic diarrhea who lived in Beijing, Henan and Xinjiang.Samples were concentrated by Formalin-Ethyl Acetate Sedimentation technique and stained by modified acid-fast stain (AFS) for the identification of oocysts by microscopy. CD4+T cells count was performed by Flow Cytometry. Results The overall infection rate of Cryptosporidium in AIDS patients was 12.6％(32/253). The infection rates of oocysts in the area of Beijing, Henan and Xinjiangwere 5.97％ ( 4/67 ), 16.1％ (24/149 ) and 1 0.8％ (4/37) respectively. The infection rate of oocysts in the urban areas was 6.5％(7/104) while in the countryside it was 16.8％(25/149) and the difference was significantly different. However, there were no any differences discovered between the infection rates on patient' s gender or on infection occurred in different seasons. The infectious rates of ooeyst in patients on different stages of the disease were also significantly different (P＜0.01). Conclusion AIDS patients infected by Cryptosporidium were not rarely seen in northern China. The rate of infection was not associated with patient' s gender but was associated with patient' s living environments. Patients living in the countryside, with lower lever of CD4 +T cells counts and at the middle/late stage of the disease, Cryptosporidium infection appeared to be high.