艾滋病合并卡氏肺孢子虫肺炎的临床特点及诊断方法  

Clinical characteristics and diagnosis of Pneumocystis carinii pneumonia (PCP) in patients with the acquired immunodeficiency syndrome (AIDS)

作　　者：张可[1] 徐斌[1] 吴昊[1] 徐莲芝[1] 赵大伟[1] 马大庆[2] 秦树林[3] 滑立伟[3] 

机构地区：[1]北京佑安医院感染科,100054 [2]北京友谊医院放射科 [3]北京协和医院感染科

出　　处：《中华结核和呼吸杂志》2002年第8期475-477,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　探讨艾滋病合并卡氏肺孢子虫肺炎 (PCP)的临床特点和诊断方法。方法　对1 999～ 2 0 0 1年经痰聚合酶链反应 (PCR)确诊的 1 2例艾滋病合并PCP进行分析。结果　 (1 )合并结核病 4例 ,细菌性肺炎 1例。 (2 )痰PCR阳性 1 2例 ,其中血PCR阳性 9例 ,姬姆萨染色阳性 6例 ,六胺银染色阳性 5例。 (3) 1 2例CD+ 4(5～ 1 55)× 1 0 6 /L ,平均CD+ 4(51± 48)× 1 0 6 /L ;其中CD+ 4<(1 0 0× 1 0 6 ) /L1 0例 (83 % ) ,CD+ 4<(50× 1 0 6 ) /L 9例 (75 % ) ;CD+ 4/CD+ 8:0 .0 1～ 0 .2 9。结论　 (1 )PCP是艾滋病晚期常见的合并症 ,常常合并其它机会性感染如结核等。 (2 )痰PCR阳性 +典型的临床表现可以确诊PCP。Objective To explore the clinical characteristics and the diagnostic methods for PCP in patients with AIDS Methods Twelve cases of AIDS associated PCP confirmed by sputum polymerase chain reaction (PCR) were analyzed Results Tuberculosis was found in 4 cases and pneumonia in 1 case of PCP. Sputum PCR was positive in all the 12 cases, of them blood PCR was positive in 9, Gomori methenamine silver stain (GMS)positive in 5 and Giemsa stain positive in 6 cases. The CD + 4 lymphocyte count was (5～155)×10 6 /L ,with a mean of (51±48)×10 6/L;the number of CD + 4 cells less than 100×10 6/L in 10 cases(83%) with 9 cases (75%) less than 50×10 6/L. The CD + 4/CD + 8 ratio was 0.01～0.29 Conclusions PCP was common in patients with advanced AIDS and often co infected with other opportunistic infections such as tuberculosis. A diagnosis of PCP should be considered if sputum PCR is positive and typical clinical manifestations are present in patients with AIDS.

关 键 词：艾滋病 卡氏肺孢子虫肺炎 临床特点 诊断 合并症 PCR 

分 类 号：R563.1[医药卫生—呼吸系统]