马尔尼菲青霉菌病的临床特征与实验室检测结果分析  

Analysis of the clinical characteristics and laboratory test results of Penicilliosis marneffei

作　　者：赵瑾 方芳[1] 乐英棒 李一荣[1] 郭清莲[1] ZHAO Jin;FANG Fang;YUE Ying-bang;LI Yi-rong;GUO Qing-lian(Department of Clinical Laboratory,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,CHINA)

机构地区：[1]武汉大学中南医院检验科,湖北武汉430071

出　　处：《海南医学》2018年第19期2735-2738,共4页Hainan Medical Journal

基　　金：国家科技重大专项课题(编号:2017zx10103005)

摘　　要：目的了解马尔尼菲青霉菌病的临床特征与实验室特征,为马尔尼菲青霉菌病的早期诊断提供客观依据。方法回顾性分析2013年12月至2018年4月武汉大学中南医院收治的63例马尔尼菲青霉菌病患者的临床特征和实验室检查结果。结果马尔尼菲青霉菌病的临床表现中发热、肺部感染和口腔损害的比率分别为90.5%、68.3%、47.6%;感染患者中血培养和骨髓培养平均报告时间分别为5.6 d和4.9 d;外周血红细胞、白细胞、血小板、CD4/CD8值、白蛋白和白球比值下降的发生率分别为96.8%、50.0%、98.4%、100.0%、91.9%和98.4%,而降钙素原升高和真菌1,3-β-D葡聚糖定量试验阳性的发生率分别为91.2%和59.5%;39例(61.9%)患者经抗真菌治疗好转出院。结论免疫功能低下特别是艾滋病患者,如果出现高热症状,且降钙素原或真菌1,3-β-D葡聚糖试验阳性,CD4/CD8值显著下降,要高度怀疑马尔尼菲青霉菌的感染。Objective To analyze the clinical characteristics and laboratory features of Penicilliosis marneffei（PSM）, and to provide an objective basis for the early diagnosis of PSM. Methods A retrospective analysis was performed on the clinical characteristics and laboratory findings of 63 patients with PSM admitted to Zhongnan Hospital of Wuhan University from December 2013 to April 2018. Results The rates of fever, lung infection and oral injury in the clinical manifestations of PSM was 90.5%, 68.3% and 47.6%, respectively. The average time taken to report positive results in blood culture and bone marrow culture for infected patients was 5.6 days and 4.9 days, respectively. The incidence of decline in peripheral erythrocyte, leukocyte, platelet, CD4/CD8 ratio, albumin, and albumin/globulin ratio was96.8%, 50.0%, 98.4%, 100.0%, 91.9% and 98.4%, respectively, while the incidence of elevations in procalcitonin and of positive fungal（1,3）-β-D glucan assay for quantification were 91.2% and 59.5%, respectively. Among the 63 patients,39（61.9%） were discharged after antifungal therapy. Conclusion For those with immune dysfunction, especially AIDS patients, if there is a symptom of high fever, the procalcitonin or fungal（1,3）-β-D glucan test is positive, and the CD4/CD8 ratio is significantly decreased, it should be highly suspected to be PSM infection.

关 键 词：马尔尼菲青霉菌 艾滋病 降钙素原 真菌1 3-β-D葡聚糖检测 

分 类 号：R515[医药卫生—内科学]