尿真菌检查对HIV／AIDS患者马尔尼菲青霉病的诊断意义  

Evaluation of Urine Fungal Examination for Diagnosis of Penicilliosis Marneffei in HIV/AIDS Patients

作　　者：谢婷[1] 李希清[1] 张军民[1] 鲁长明[1] 曾常红[2] 蔡卫平[3] 陈谐捷[3] 席丽艳[1] 

机构地区：[1]中山大学附属第二医院皮肤科,广东广州510120 [2]广东省疾病预防控制中心,广东广州510250 [3]广州市第八人民医院感染科,广东广州510060

出　　处：《中山大学学报（医学科学版）》2009年第3期341-343,356,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：卫生部公益性行业科研专项基金(200802026);广东省医学科学技术研究基金(2006A199)

摘　　要：【目的】探讨尿真菌镜检与培养对HIV/AIDS患者马尔尼菲青霉病的诊断意义。【方法】分别同时对166例HIV/AIDS患者的尿液进行真菌镜检、培养,并作血真菌培养,检测尿标本马尔尼菲青霉的阳性率、灵敏度,并与血液真菌培养进行比较。【结果】166例HIV/AIDS患者中,确诊马尔尼菲青霉病患者26例(阳性率15.66%),马尔尼菲青霉血尿检查总阳性24例(14.46%)。尿镜检阳性3例(1.81%),尿培养阳性14例(8.43%),血培养阳性19例(11.45%)。尿培养、血培养及两者联合的灵敏度分别为53.84%、73.08%和92.31%,特异度均为100%。血、尿培养的马尔尼菲青霉阳性率差异无统计学意义,但尿镜检与尿培养,尿镜检与血培养的阳性率之间,以及血培养与尿培养,尿培养与尿镜检之间的关联性存在统计学差异。【结论】尿真菌培养马尔尼菲青霉敏感性较高,方便快捷,是一种较好的HIV/AIDS患者尤其是取血困难者马尔尼菲青霉病的诊断方法,而尿真菌镜检意义不大。[Objective] To evaluate the use of urine fungal smear and culture for diagnosis of penicilliosis marneffei in HIV/AIDS patients. [Methods] Urine specimens from 166 HIV/AIDS patients were tested for Penicillium marneffei by examination of smear and culture, while blood specimens by culture only. The positive rate, sensitivity, and uniformity of urine and blood specimens were tested and compared. [Results] Of the 166 HIV/AIDS patients examined, 26（15.66%） had penieilliosis marnefei, the positive rates of penicillium marneffei in urine and blood specimen were as follows： urine and blood culture in total, 14.46% （24 cases）; urine culture, 8.43% （14 cases ）; urine smear, 1.81% （3 cases）; blood culture, 11.45% （19 cases） （The sensitivities were 92.31%, 58.33%, 12.5%, and 79.17%, respectively）. There was no statistical significance in the positive rate between urine and blood culture, while the positive rate between urine smear and urine culture, between urine smear and blood culture showed statistical significance, and the uniformities among them were not found. [Conclusion] The urine fungal culture is rapid, convenient and might be a valuable method besides blood culture for diagnosis of penieilliosis marneffei in HIV/ AIDS patients, especially when blood specimen is unavailable. While urine fungal smear is not a valuable method for diagnosis of it.

关 键 词：尿 人类免疫缺陷病毒 获得性免疫缺陷综合征 马尔尼菲青霉 马尔尼菲青霉病 

分 类 号：R75[医药卫生—皮肤病学与性病学]