中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
3期
461-465
,共5页
张培荣%晏斌林%徐加誉%廖子龙%黄建鑫%刘昭红
張培榮%晏斌林%徐加譽%廖子龍%黃建鑫%劉昭紅
장배영%안빈림%서가예%료자룡%황건흠%류소홍
高碘酸-雪夫染色反应%MUC5B%念珠菌探针%早期真菌感染
高碘痠-雪伕染色反應%MUC5B%唸珠菌探針%早期真菌感染
고전산-설부염색반응%MUC5B%념주균탐침%조기진균감염
Periodic acid-Schiff reaction%MUC5B%Candida probe%Early-stage fungal infection
目的：探讨真菌感染早期的病理诊断方法，提高真菌阳性检出率，有效指导临床治疗。方法将2011年至2013年痰、胸水、腹水、表面皮肤刮片等脱落细胞标本，经薄层液基细胞制片（TCT）检测选取78例标本，对标本制备的细胞块连续切片经特殊染色 PAS、免疫组化 MUC5B、原位杂交念珠菌探针方法，对患者年龄、性别及健康状况的真菌阳性率进行数据分析，对 PAS、MUC5B 两种检测方法的相关性进行分析，比较传统及科研检测早期诊断真菌感染的方法差异性。结果78例标本中三种检测方法在年龄组、性别组均无统计学差异（P＞0.05），PAS 在健康状况组无统计学差异（P＞0.05），MUC5B、念珠菌探针在健康状况组中均有统计学差异（P＜0.05）；PAS与MUC5B表达的统计学分析有统计学差异，两者之间具有相关性（P＜0.05，r＝0.236），传统及科研检测早期诊断真菌感染的方法进行比较具有统计学差异（P＜0.01）。结论通过数据统计健康状况较差的人群中真菌抗体MUC5B及念珠菌检出率高于健康状况良好的人群；MUC5B真菌阳性检出率显著高于 PAS 染色；本科研方法真菌阳性检出率明显高于传统真菌检测方法；采用 PAS与MUC5B及念珠菌探针联合应用能提高真菌阳性检出率及达到对真菌的初步分类。
目的：探討真菌感染早期的病理診斷方法，提高真菌暘性檢齣率，有效指導臨床治療。方法將2011年至2013年痰、胸水、腹水、錶麵皮膚颳片等脫落細胞標本，經薄層液基細胞製片（TCT）檢測選取78例標本，對標本製備的細胞塊連續切片經特殊染色 PAS、免疫組化 MUC5B、原位雜交唸珠菌探針方法，對患者年齡、性彆及健康狀況的真菌暘性率進行數據分析，對 PAS、MUC5B 兩種檢測方法的相關性進行分析，比較傳統及科研檢測早期診斷真菌感染的方法差異性。結果78例標本中三種檢測方法在年齡組、性彆組均無統計學差異（P＞0.05），PAS 在健康狀況組無統計學差異（P＞0.05），MUC5B、唸珠菌探針在健康狀況組中均有統計學差異（P＜0.05）；PAS與MUC5B錶達的統計學分析有統計學差異，兩者之間具有相關性（P＜0.05，r＝0.236），傳統及科研檢測早期診斷真菌感染的方法進行比較具有統計學差異（P＜0.01）。結論通過數據統計健康狀況較差的人群中真菌抗體MUC5B及唸珠菌檢齣率高于健康狀況良好的人群；MUC5B真菌暘性檢齣率顯著高于 PAS 染色；本科研方法真菌暘性檢齣率明顯高于傳統真菌檢測方法；採用 PAS與MUC5B及唸珠菌探針聯閤應用能提高真菌暘性檢齣率及達到對真菌的初步分類。
목적：탐토진균감염조기적병리진단방법，제고진균양성검출솔，유효지도림상치료。방법장2011년지2013년담、흉수、복수、표면피부괄편등탈락세포표본，경박층액기세포제편（TCT）검측선취78례표본，대표본제비적세포괴련속절편경특수염색 PAS、면역조화 MUC5B、원위잡교념주균탐침방법，대환자년령、성별급건강상황적진균양성솔진행수거분석，대 PAS、MUC5B 량충검측방법적상관성진행분석，비교전통급과연검측조기진단진균감염적방법차이성。결과78례표본중삼충검측방법재년령조、성별조균무통계학차이（P＞0.05），PAS 재건강상황조무통계학차이（P＞0.05），MUC5B、념주균탐침재건강상황조중균유통계학차이（P＜0.05）；PAS여MUC5B표체적통계학분석유통계학차이，량자지간구유상관성（P＜0.05，r＝0.236），전통급과연검측조기진단진균감염적방법진행비교구유통계학차이（P＜0.01）。결론통과수거통계건강상황교차적인군중진균항체MUC5B급념주균검출솔고우건강상황량호적인군；MUC5B진균양성검출솔현저고우 PAS 염색；본과연방법진균양성검출솔명현고우전통진균검측방법；채용 PAS여MUC5B급념주균탐침연합응용능제고진균양성검출솔급체도대진균적초보분류。
Objective To explore the pathological diagnosis methods for early stage of fungal infection in order to improve the positive detection ratio of fungus, and to guide the clinical treatment effectively. Methods Assaying the exfoliated cells specimens such as phlegm, pleural effusion, ascites, the carbon blade of surface skin, etc collected from 2011 to 2013 by means of Thinprep cytologic test(TCT) method. In our assay, we selected 78 cases of specimens, conducted serial section on cell block prepared from the specimens and performed data analysis to the fungi positive detection ratio of the patients in different age, gender and health status through special staining PAS and immunohistochemical MUC5B and in situ hybridization method with candida probe, the correlation of two testing methods, PAS and MUC5B, and the comparing traditional method to detect diagnosis to the early stage of fungal infection of our scientific research to illustrate the difference between this two methods. Results In different age and gender groups of 78 cases of specimens, there was no significant difference among data analysis results of the three assay methods(P>0.05), there was no significant difference among analysis results for the PAS method of different Health groups(P>0.05), there was significant difference between the statistical analysis results expressed by means of PAS and MUC5B methods, and there was correlation in the analysis results of the two methods(P<0.05, r=0.236). Conclusions The data statistics revealed that for fungus antibody MUC5B and candida fungus method, the detection ratios of are higher in the population in poor health than it in the population in good health;the detection ratios by means of fungus antibody MUC5B method was higher than it by means of PAS dye;and the detection ratios by means of this science research method was higher than it by means of traditional assay method;thus the combined application of PAS, MUC5B and candida probe can improve positive detection ratio of the fungus to meet the requirement of the preliminary classification to the fungus.
