HIV/AIDS患者人芽囊原虫3种检测方法评价  

Evaluation of three methods for detecting Blastocystis hominis in HIV/AIDS patients

作　　者：胡主花 钱科 彭国华 冯小武 田利光[2] HU Zhuhua;QIAN Ke;PENG Guohua;FENG Xiaowu;TIAN Liguang(The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control,Jiangxi Provincal Key Laboratory of Animal-origin and Vector-borne Diseases,Nanchang Center for Disease Control and Prevention,Nanchang,Jiangxi 330038,China;Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,Shanghai 200025,China)

机构地区：[1]传染病预防控制国家重点实验室研究基地,江西省动物源与媒介生物性传染病重点实验室,南昌市疾病预防控制中心,江西南昌330038 [2]中国疾病预防控制中心寄生虫病预防控制所,上海200025

出　　处：《中国热带医学》2020年第3期285-287,共3页China Tropical Medicine

基　　金：江西省卫生计生委科技计划(No.20186023)。

摘　　要：目的对HIV/AIDS患者粪便中人芽囊原虫的3种检测方法进行评价,为开展大规模人芽囊原虫感染的流行病学调查提供适合的方法。方法采集抗病毒治疗及艾滋病自愿咨询检测(VCT)的HIV/AIDS患者粪便,采用生理盐水涂片法、碘液染色法和体外培养法检测人芽囊原虫,同时通过对PCR产物测序确定人芽囊原虫阳性结果。结果共检测调查对象粪样505份,生理盐水涂片法、碘液染色法和体外培养法阳性率分别为2.57%(13/505)、2.77%(14/505)和3.96%(20/505),PCR扩增产物测出22份人芽囊原虫序列,阳性率为4.36%(22/505),4种方法阳性率差异无统计学意义(P>0.05)。以PCR作为参比方法,3种方法的特异度和阳性预测值一致,均为100.00%(483/483);体外培养法的灵敏度86.36%明显高于生理盐水涂片法54.55%和碘液染色法59.09%,体外培养法阴性预测值99.38%、符合率99.41%和约登指数0.86均略高于生理盐水涂片法97.97%、98.02%、0.55及碘液染色法98.17%、98.22%、0.59。结论人芽囊原虫体外培养法灵敏度最高,适合基层开展大规模人芽囊原虫感染的流行病学调查。Objective Three methods for detecting Blastocystis hominis in the feces of HIV/AIDS patients were evaluated to provide a basis for epidemiological investigation methods for the infection of B.hominis.Methods The feces of HIV/AIDS patients treated with antiviral therapy and VCT(Voluntary Counseling and Testing)were collected and then detected by physiological saline method of direct smear,iodine method of direct smear and culture in vitro.The positive results of B.hominis were determined by PCR.Results A total of 505 fecal samples were tested,the highest positive rate among the three methods was culture in vitro(3.96%,20/505),followed by iodine method of direct smear(2.77%,14/505)and physiological saline method of direct smear(2.57%,13/505);22 positive results(4.36%,22/505)were detected by PCR.There was no significant difference in the positive rates of the four methods(P>0.05).Using PCR as a reference method,the specificity and the positive predictive value of the three methods were the same,100.00%(483/483).The sensitivity of 86.36%culture method in vitro was significantly higher than that of 54.55%in physiological saline smear method and 59.09%in iodine method of direct smear.The negative predictive value was 99.38%,the coincidence rate of 99.41%and the yodon index was 0.86 of culture method in vitro,which were slightly higher than that of physiological saline smear method,97.97%,98.02%,0.55,and iodine method of direct smear 98.17%,98.22%,0.59,respectively.Conclusion The method of culture in vitro has the highest sensitivity and is suitable for the epidemiological investigation of infection with B.hominis.

关 键 词：人类免疫缺陷性病毒 艾滋病 人芽囊原虫 生理盐水涂片法 碘液染色法 体外培养法 

分 类 号：R512.91[医药卫生—内科学]