隐球菌荚膜多糖抗原检测对人类免疫缺陷病毒感染继发隐球菌脑膜炎患者的临床价值  

The significance and therapy monitoring of detection cryptococcal capsular polysaccharide antigen in HIV-positive patients with secondary cryptococcal meningitis

作　　者：尚鹏程[1] 许娇[1] 裴晓芳[1] 

机构地区：[1]四川大学华西公共卫生学院,四川成都610000

出　　处：《国际检验医学杂志》2015年第19期2836-2837,2839,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨隐球菌荚膜多糖抗原检测对HIV感染继发隐球菌脑膜炎患者诊断及治疗观察的意义。方法 2012年1月至2013年5月华西医院HIV感染继发隐球菌脑膜炎患者23例。采集隐球菌脑膜炎治疗前后的脑脊液和血清标本,作墨汁染色并用APl20CAUX真菌鉴定试剂条鉴定到种,行隐球菌荚膜抗原检测,并对其中13例患者治疗前后脑脊液和血清标本中荚膜抗原滴度变化进行配对t检验。结果治疗后脑脊液和血清标本中隐球菌荚膜抗原滴度下降,与治疗前比较,差异均有统计学意义(P<0.05);13例患者隐球菌脑膜脑炎治疗有效,但真菌培养及涂片均显示阴性后,部分患者隐球菌荚膜抗原仍为阳性。结论隐球菌荚膜抗原检测有利于提高HIV感染继发隐球菌脑膜炎患者的早期诊断;抗原滴度能用来判断疗效,但不能作为治愈指标。Objective To discuss the significance and therapy monitoring of detection cryptococcal capsular polysaecharide anti- gen in HIV-positive patients with secondary cryptococcal meningitis. Methods Cerebrospinal fluid and serum samples of 23 HIV positive patients with secondary cryptococcal meningitis were collected,retrospective analysis was conducted in the capsular antigen titer changes data which from 23 patients with the cerebrospinal fluid（CSF） and serum samples before and after treatment. And the capsular antigen in 13 patients before and after treatment of CSF and serum specimens were compared in matching t test. Results The CSF and serum samples before and after treatment of cryptococcal capsular antigen titer decreased both with statistical signifi- cance（P^0. 01） ,but by effective treatment and fungal culture and smears were negative in the 13 patients,the cryptococcal capsu lar antigen was still positive. Conclusion Cryptococcal capsular antigen test could help improve HIV-infected patients with crypto coccal meningitis secondary to early diagnosis,it could be used to determine the efficacy of antigen titer, but not as a cure indicator.

关 键 词：人类免疫缺陷病毒 隐球菌荚膜多糖抗原 隐球菌性脑膜炎 乳胶凝集 

分 类 号：R512.91[医药卫生—内科学] R519[医药卫生—临床医学] R446.6