G试验和淋巴细胞亚群对免疫功能低下合并耶氏肺孢子菌肺炎的诊断价值  

Values of G test and lymphocyte subsets in diagnosis of Pneumocystis jirovecii pneumonia in immunocompromised patients

作　　者：仇先明 徐朋 周蕾 郝浩[3] 孔立[3] QIU Xianming;XU Peng;ZHOU Lei;HAO Hao;KONG Li(The First Hospital Affiliated with Shandong First Medical University,Jinan,Shandong 250014,China;不详)

机构地区：[1]山东第一医科大学第一附属医院重症医学科,山东济南250014 [2]山东第一医科大学第一附属医院感染管理科,山东济南250014 [3]山东中医药大学附属医院重症医学科,山东济南250014

出　　处：《中华医院感染学杂志》2025年第6期854-857,共4页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展基金资助项目(2018WS099)。

摘　　要：目的分析免疫功能低下合并耶氏肺孢子菌肺炎(PJP)临床资料,探讨G试验和淋巴细胞亚群对免疫功能低下合并耶氏肺孢子菌肺炎的诊断价值。方法选择2019年1月-2021年12月山东第一医科大学第一附属医院呼吸重症病房收治的78例免疫功能低下患者为研究对象,其中39例PJP肺炎患者为PJP组,39例未检出PJP的患者为非PJP组,比较两组患者临床资料,采用受试者工作特征(ROC)曲线分析各实验室指标对免疫功能低下患者感染PJP的诊断价值。结果PJP组患者病死率高于非PJP组患者(P<0.05)。PJP组和非PJP组患者白细胞计数(WBC)、中性粒细胞计数(Neu)、血小板分布宽度(PDW)、降钙素原(PCT)、C-反应蛋白(CRP)、GM试验、G试验[(1843.59±1621.41)pg/ml vs.(87.15±111.01)pg/ml]和CD8淋巴细胞比例[(36.22±19.34)%vs.(25.99±13.10)%]比较,差异有统计学意义(P<0.05)。G试验和CD8淋巴细胞比例诊断免疫功能低下患者感染PJP肺炎的曲线下面积(AUC)分别是0.981和0.714,截断值分别是368.40 pg/ml和31.30%。结论免疫功能低下合并重症肺炎患者病死率高,需要临床医生引起重视。G试验和CD8淋巴细胞比例对免疫功能低下患者合并PJP具有一定的诊断价值。OBJECTIVE To analyze the clinical data of the immunocompromised patients complicated with Pneumocystis jirovecii pneumonia(PJP)and explore the values of G test and lymphocyte subsets in diagnosis of the PJP in the immunocompromised patients.METHODS A total of 78 immunocompromised patients who were treated in respiratory intensive care unit of the First Affiliated Hospital of Shandong First Medical University from Jan.2019 to Dec.2021 wee recruited as the research subjects,39 of whom had PJP and were assigned as the PJP group,39 did not have PJP and were assigned as the non-PJP group.The clinical data were compared between the two groups.The values of the clinical laboratory test indexes in diagnosis of PJP in the immunocompromised patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The mortality rate of the PJP group was higher than that of the non-PJP group(P<0.05).There were significant differences in the white blood cell(WBC)counts,neutrophils(Neu)counts,platelet distribution width(PDW),procalcitonin(PCT),C-reactive protein(CRP)and GM test between the PJP group and the non-PJP group;the G test was(1843.59±1621.41)pg/ml in the PJP group,(87.15±111.01)pg/ml in the non-PJP group;the percentage of CD8 lymphocyte was(36.22±19.34)%in the PJP group,(25.99±13.10)%in the non-PJP group,and there were significant differences(P<0.05).The areas under the curves(AUCs)of the G test and the percentage of CD8 lymphocyte were respectively 0.981 and 0.714 in diagnosis of PJP in the immunocompromised patients,and the cutoff values were 368.40 pg/ml and 31.30%,respectively.CONCLUSIONS It is necessary for the clinicians to pay great attention to the high mortality rate of the immunocompromised patients complicated with severe pneumonia.The G test and the percentage of CD8 lymphocyte have certain values in diagnosis of PJP in the immunocompromised patients.

关 键 词：免疫功能低下 耶氏肺孢子菌肺炎 G试验 淋巴细胞亚群 

分 类 号：R519.8[医药卫生—内科学]