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目的分析在艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中,应用血清隐球菌抗原筛查隐球菌感染的结果,为开展相关研究提供依据。方法对2012年10月至2013年7月,在贵阳市第五人民医院住院的348例HIV/AIDS病人进行血清隐球菌抗原检查,同时检查病人的CD+4T淋巴细胞(简称CD4细胞)计数;对血清隐球菌抗原阳性病人进行血培养、脑脊液(CSF)隐球菌抗原检查、墨汁染色及培养。结果 348例病人中,男256例,女92例,年龄19~77岁,平均(40.50±13.05)岁。血清隐球菌抗原阳性34例,阳性率9.77%(34/348),CD4细胞计数为0~1097个/mm3,中位数56个/mm3。CD4细胞计数≤50个/mm3组146例,>50个/mm3组202例。CD4细胞计数≤50个/mm3和>50个/mm3组病人阳性例数分别为24例和10例,阳性率为16.44%(24/146)和4.95%(10/202),两组间差异有统计学意义(u=3.56,P<0.01)。血清隐球菌抗原阳性病人血培养阳性3例,CSF隐球菌抗原阳性27例,墨汁染色阳性22例,CSF培养阳性15例;34例病人中最后确认隐球菌感染33例。所有诊断隐球菌感染的病人血清隐球菌抗原均为阳性。结论 HIV/AIDS病人血清隐球菌抗原阳性率高,血清隐球菌抗原筛查有助于及时诊断隐球菌病,特别是CD4细胞计数≤50个/mm3的病人,推荐普遍检查。
Objective To analyze the results of screening Cryptococcus neoformans infection with Cryptococcus neoformans antigen in HIV / AIDS patients (referred to as HIV / AIDS patients), and provide the basis for the related research. Methods A total of 348 HIV / AIDS patients hospitalized in the Fifth People’s Hospital of Guiyang from October 2012 to July 2013 were tested for cryptococcal antigen. At the same time, the counts of CD + 4T lymphocytes (CD4 cells) were counted. Blood cultures, cerebrospinal fluid (CSF) cryptococcal antigen tests, ink stains, and culture were performed on patients with positive Cryptococcus antigen. Results Of the 348 patients, 256 were male and 92 were female, ranging in age from 19 to 77 years (mean, 40.50 ± 13.05) years. Serum cryptococcal antigen positive in 34 cases, the positive rate was 9.77% (34/348), CD4 cell count was 0 ~ 1097 / mm3, the median 56 / mm3. There were 146 cases with CD4 count ≤50 / mm3 and 202 cases with> 50 / mm3. The number of positive cases with CD4 counts ≤50 / mm3 and> 50 / mm3 were 24 cases and 10 cases respectively, the positive rates were 16.44% (24/146) and 4.95% (10/202) respectively. There was significant difference between the two groups There was statistical significance (u = 3.56, P <0.01). Serum cryptococcal positive patients positive for blood culture in 3 cases, CSF Cryptococcal antigen in 27 cases, ink stain in 22 cases, CSF culture positive in 15 cases; 34 cases of the final confirmation of cryptococcal infection in 33 cases. All patients with cryptococcal disease were positive for cryptococcal antigen. Conclusion The positive rate of serum cryptococcal antigen in HIV / AIDS patients is high. Screening of serum cryptococcal antigen is helpful for the timely diagnosis of cryptococcosis, especially in patients with CD4 cell count ≤50 / mm3.