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重庆医科大学附属第一医院感染科,重庆,400016
纸质出版日期:2014,
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佘 轩, 姚云清, 李佳俊, 等. 重庆地区HIV阴性免疫力低下患者肺孢子感染率研究分析[J]. 重庆医科大学学报, 2014,38(9):1250-1254.
She Xuan, Yao Yunqing, Li Jiajun, et al. Infection rate of pneumocystis in immunocompromised patients without HIV infection in Chongqing[J]. Journal of Chongqing Medical University, 2014,38(9):1250-1254.
目的:探讨重庆地区人类免疫缺陷病毒(human immunodeficiency virus,HIV)阴性免疫力低下患者肺孢子(pneumocys-tis carinii,PC)感染率,为临床上HIV阴性患者合并PC感染的早期诊断及治疗提供生物学依据。方法:取71例HIV阴性免疫力低下患者的痰液标本,分别运用六亚甲基四胺银染色法(gomort methenamine silver stain,GMS)和内转录间隔区(internal tran-scribed spacer,ITS)-巢式PCR法检测标本中肺孢子。结果:71例患者痰液标本中,GMS染色法检测出PC 2例,巢式PCR法检测出PC 25例,差异有统计学意义( ?字2=21.04,P=0.000);不同性别患者PC感染率无统计学差异( ?字2=0.375,P=0.540);不同年龄阶段患者PC感染率无统计学差异( ?字2=0.777,P=0.678)。肿瘤放化疗后患者、血液系统疾病患者、肾移植患者、肝移植患者、结缔组织疾病患者感染率分别为33.33%、26.67%、40.00%、42.86%、39.13%,采用Fisher确切概率法对不同病例组感染率进行比较,各病例组间感染率差异无统计学意义(P=0.897),但本组病例PC感染率显著高于同期国外报道,与2009年国内报道感染率相当。结论:重庆地区HIV阴性免疫力低下患者PC感染率较高,临床医师应增强对该类患者是否合并PC感染的警觉性。
Objective:To investigate the infection rate of pneumocystis carinii(PC) in human immunodeficiency virus(HIV) negative immunocompromised patients in Chongqing in order to provide biological references for its early diagnosis and treatment. Methods:Sputum specimens were collected from 71 HIV-negative immunocompromised patients in Chongqing and were detected by Gomori’s methenamine silver stained(GMS) and internal transcribed spacer(ITS)-nested PCR,respectively. Results:PC was detected out in two cases out of 71 cases by GMS and PC was detected out in 25 cases by nested PCR,the difference between the two methods were significant(?字2=21.04,P=0.000) .There was no significant difference in infection rate between difference genders( ?字2=0.375,P=0.540) and different ages(?字2=0.777,P=0.678). The infection rates of patients with cancer,heamatolagic disorder,kidney transplantation,liver transplantation and connective tissue disease were 33.33%,26.67%,40.00%,42.86% and 39.13% respectively. There was no signifi-cant difference in infection rates between the different case groups(P=0.897). The infection rate was significantly higher than that of abroad report and was the same as that of domestic report in 2009. Conclusion:The infection rate of PC of HIV-negative immuno-compromised patients in Chongqing is high. Clinician should enhance the alertness of patients with PC.
HIV阴性免疫力低下者肺孢子感染率
human immunodeficiency virus-negativeimmunocompromised patientsinfection rate of pneumocystis jirovecii
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