HIV/AIDS患者分枝杆菌检出情况分析  

Analysis of Mycobacterium infection in HIV/AIDS patients

作　　者：代芳芳[1] 鲁辛辛[2] 于艳华[1] 陈铭[1] 孙桂珍[1] DAI Fangfang;LU Xinxin;YU Yanhua;CHEN Ming;SUN Guizhen(Department of Clinical Laboratory,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Department of Clinical Laboratory,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京佑安医院临床检验中心,北京100069 [2]首都医科大学附属北京同仁医院检验科,北京100176

出　　处：《检验医学》2023年第12期1173-1176,共4页Laboratory Medicine

基　　金：科技部基础资源调查专项(2019FY101212)。

摘　　要：目的分析人类免疫缺陷病毒(HIV)感染/获得性免疫缺陷综合征(AIDS)患者合并分枝杆菌感染的实验室检出情况。方法收集2018年1月—2021年12月首都医科大学附属北京佑安医院HIV/AIDS患者送检的1379例分枝杆菌抗酸染色样本、1975例分枝杆菌培养样本、1406例结核分枝杆菌(MTB)聚合酶链反应(PCR)检测样本和522例γ-干扰素释放试验(IGRA)样本实验室检测结果,分析不同检测方法分枝杆菌阳性检出情况和联合检出情况。结果抗酸染色、培养、MTB-PCR、IGRA分枝杆菌阳性率分别为3.41%、5.47%、5.83%、11.49%。同时送检抗酸染色和MTB-PCR或IGRA时,抗酸染色阳性率有所上升;同时送检培养和MTB-PCR或IGRA时,培养法阳性率有所上升;4种方法均送检时阳性率高,且易鉴别出MTB和非结核分枝杆菌(NTM)。MTB-PCR和IGRA为鉴定MTB的特异性方法,2种方法鉴定结果一致性较好。结论抗酸染色法和培养法检测HIV/AIDS患者合并分枝杆菌感染阳性率较低,PCR和IGRA可有效鉴别MTB和NTM。临床高度怀疑HIV/AID患者分枝杆菌感染时,建议多种方法联合检测。Objective To analyze the determination of Mycobacterium infection in human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)patients.Methods Totally,1379 Mycobacterium acid-fast staining specimens,1975 Mycobacterium culture specimens,1406 Mycobacterium tuberculosis(MTB)-polymerase chain reaction(PCR)specimens and 522 interferon-gamma release assay(IGRA)specimens were collected from HIV/AIDS patients from January 2018 to December 2021 Beijing Youan Hospital of Capital Medical University.The results of these specimens by the 4 methods were analyzed and compared retrospectively.Results The positive rates of acid-fast staining,culture,MTB-PCR and IGRA were 3.41%,5.47%,5.83% and 11.49%,respectively.The positive rates of acid-fast staining and culture were improved,when they were determined with MTB-PCR or IGRA.The positive rate was high when the 4 methods were used simultaneously,and it was easy to distinguish MTB from non-tuberculous Mycobacterium(NTM).MTB-PCR and IGRA were the specific methods for the identification of MTB,and their identification results were consistent.Conclusions In HIV/AIDS patients with Mycobacterium infection,the positive rates of acid-fast staining and culture are low.MTB-PCR and IGRA can distinguish MTB from NTM.When HIV/AIDS patients are suspected with Mycobacterium infection,it is recommended to combine multiple determination methods.

关 键 词：人类免疫缺陷病毒 分枝杆菌 抗酸染色 培养 聚合酶链反应 Γ-干扰素释放试验 

分 类 号：R446.1[医药卫生—诊断学]