CAJ | 학술논문

目的：评价拟诊标准（血清AST水平高于正常值上限2倍且大于ALT）对AIDS合并马尔尼菲青霉菌病（penicil-liosis marneffei, PSM）的筛查价值。方法对广西地区1045例疑似AIDS合并PSM的患者同时进行“金标准”（血、骨髓、组织培养或组织病理发现马尔尼菲青霉菌）及拟诊标准所需检查，评价拟诊标准对AIDS合并PSM的诊断价值。结果拟诊标准的灵敏度为45.79％、假阴性率42.11％、特异度90.64％、假阳性率9.36％、准确度82.49％、阳性似然比4.89、阴性似然比0.60、阳性预测值52.10％、阴性预测值88.27％。结论 AIDS患者如出现血清AST水平高于正常值上限2倍且大于ALT时，尚不能作为筛查PSM的常规指标，但应高度警惕PSM。
목적：평개의진표준（혈청AST수평고우정상치상한2배차대우ALT）대AIDS합병마이니비청매균병（penicil-liosis marneffei, PSM）적사사개치。방법대엄서지구1045례의사AIDS합병PSM적환자동시진행“금표준”（혈、골수、조직배양혹조직병리발현마이니비청매균）급의진표준소수검사，평개의진표준대AIDS합병PSM적진단개치。결과의진표준적령민도위45.79％、가음성솔42.11％、특이도90.64％、가양성솔9.36％、준학도82.49％、양성사연비4.89、음성사연비0.60、양성예측치52.10％、음성예측치88.27％。결론 AIDS환자여출현혈청AST수평고우정상치상한2배차대우ALT시，상불능작위사사PSM적상규지표，단응고도경척PSM。
Objective To evaluate the screening value of AIDS patients complicated with penicilliosis marneffei when AST elevates more than twice the upper limit of normal and higher than ALT. Methods A total of 1045 AIDS patients complicated with suspected penicilliosis marneffei (PSM) in Guangxi undertook the examinations by“gold standard”(Penicillium marneffei found in culture of blood, marrow and tissue, or by biopsy) and the preliminary diagnostic standard. The diagnostic value of the preliminary diagnostic standard in AIDS patients complicated with PSM was evaluated. Results The sensitivity of the preliminary diagnostic standard was 45.79%, false negative rate 42.11%, specificity 90.64%, false positive rate 9.36%, accuracy rate 82.49%, positive likelihood ratio 4.89, negative likelihood ratio 0.60, positive predictive value 52.10%, and negative predictive value 88.27%.Conclusions When AST level elevates more than twice the upper limit of normal and higher than ALT level, AIDS patients can not be diagnosed as PSM, but great concern should be given to the occurrence of PSM.