CAJ | 학술논문

目的：探讨获得性免疫缺陷综合征（AIDS）合并马尔尼菲青霉病（PSM）的实验室诊断方法。方法采用回顾性研究对257例AIDS 患者骨髓和血液真菌培养以及骨髓涂片镜检检测马尔尼菲青霉（PM）的结果进行统计分析。结果共检出PM77例，检出率为29．96％。血液及骨髓真菌联合培养检出PM74例，其中骨髓及血液培养检出PM的病例数分别为65例和54例；骨髓涂片镜检检出PM33例，其中30例经培养证实PM感染，3例培养结果阴性但临床资料支持PM诊断。以血液及骨髓联合培养阳性为金标准，AIDS 患者骨髓及血液真菌培养PM检出率分别为87．84％和72．97％，2种培养方法之间及其与2种方法联合培养比较，差异均有统计学意义（P ＜0．05），骨髓涂片镜检诊断PSM的特异性为90．91％，敏感性为44．59％。结合骨髓涂片镜检分析，血液及骨髓联合培养法诊断PSM的漏检率为3．90％。结论联合骨髓和血液真菌培养并结合骨髓涂片镜检检测PM，对提高AIDS 患者合并PSM诊断的及时率和阳性检出率有重要意义。
목적：탐토획득성면역결함종합정（AIDS）합병마이니비청매병（PSM）적실험실진단방법。방법채용회고성연구대257례AIDS 환자골수화혈액진균배양이급골수도편경검검측마이니비청매（PM）적결과진행통계분석。결과공검출PM77례，검출솔위29．96％。혈액급골수진균연합배양검출PM74례，기중골수급혈액배양검출PM적병례수분별위65례화54례；골수도편경검검출PM33례，기중30례경배양증실PM감염，3례배양결과음성단림상자료지지PM진단。이혈액급골수연합배양양성위금표준，AIDS 환자골수급혈액진균배양PM검출솔분별위87．84％화72．97％，2충배양방법지간급기여2충방법연합배양비교，차이균유통계학의의（P ＜0．05），골수도편경검진단PSM적특이성위90．91％，민감성위44．59％。결합골수도편경검분석，혈액급골수연합배양법진단PSM적루검솔위3．90％。결론연합골수화혈액진균배양병결합골수도편경검검측PM，대제고AIDS 환자합병PSM진단적급시솔화양성검출솔유중요의의。
Objective To investigate the laboratory diagnosis methods of acquired immune deficiency syndrome (AIDS)combined with penicilliosis marneffei (PSM).Methods A total of 257 AIDS patients were enrolled.Bone marrow and peripheral blood fungal dimorphic culture and bone marrow smear microscopy were performed for the detection of Penicillium marneffei (PM).The data were analyzed retrospectively.Results The 77 AIDS patients had PM,and the detection rate was 29.96%.A total of 74 patients were identified by bone marrow and peripheral blood fungal dimorphic culture,including 65 patients were positive in bone marrow,and 54 patients were positive in peripheral blood.A total of 33 patients were proved to be PM positive by bone marrow smear microscopy,including 30 patients showed positive in fungal dimorphic culture,and 3 patients showed negative but positive during therapeutic diagnosis. With the positivity of bone marrow fungal and peripheral blood fungal dimorphic culture as the good standard for PM diagnosis,the detection rate of PMby bone marrow fungal culture was 87.84%,which was significantly higher than the detection rate by peripheral blood fungal culture among AIDS patients (72.97%).The 2 individual culture rates were significant statistically with the rate of dimorphic culture (P<0.05).The detection specificity for the diagnosis of PSM by bone marrow smear microscopy was 90.91%,and the sensitivity was 44.59%.Combined with bone marrow smear microscopy,the missing rate of dimorphic culture was 3.90%.Conclusions The detection of PMby bone marrow and peripheral blood fungal dimorphic culture combined with bone marrow smear microscopy is significant in the diagnosis of AIDS combined with PM on time.