北京、河南、新疆地区HIV／AIDS相关慢性腹泻患者隐孢子虫感染检测分析

Detection of Cryptosporidium infection among HIV/AIDS patients with chronic diarrhea in Beijing,Henan and Xinjiang of China

目的了解北京、河南、新疆地区HIV感染者和艾滋病患者（HIv／AIDs）相关慢性腹泻患者中隐孢子虫感染状况。方法收集3个地区HIV／AIDS相关慢性腹泻患者粪便，采用甲醛-乙酸乙酯沉淀法集卵，用改良抗酸染色法染色检测隐孢子虫卵囊。同时检测患者血液CD4＋T淋巴细胞计数。结果253例HIV／AIDS相关慢性腹泻患者的粪便标本中有32例为隐孢子虫阳性，感染率为12．6％。北京、河南、新疆地区艾滋病慢性腹泻患者隐孢子虫感染率分别为5．97％（4／67）、16．1％（24／149）和10．8％（4／37），地区间差异有统计学意义（X2=4．431，P〈0．05）。男性和女性艾滋病慢性腹泻患者隐孢子虫感染率分别为11．2％（16／143）和14．5％（16／110），差异无统计学意义（x2=0．634，P〉0．05）；城市和农村艾滋病慢性腹泻患者隐孢子虫感染率分别为6．5％（7／104）和16．8％（25／149），差异有统计学意义（x2=5．596，P〈0．05）；夏秋季与其他季节的艾滋病慢性腹泻患者隐孢子虫感染率分别为14．0％（30／214）和5．1％（2／39），差异无统计学意义（P〉0．05）；艾滋病慢性腹泻患者处于HIV感染无症状期、有症状期、艾滋病期隐孢子虫感染率分别为0％（0／7）、21．3％（19／89）、8．3％（13／157），差异有统计学意义（X2=9．822，P〈0．01）；不同CD4＋T淋巴细胞计数水平（cell／ul）艾滋病慢性腹泻患者隐孢子虫感染率有差异，〈200为20．4％（20／98），200～499为9．23％（12／130），≥500为0％（0／25），差异有统计学意义（x2=10．33，P〈0．01）。艾滋病中晚期慢性腹泻患者，尤其是CD4＋T淋巴细胞计数〈200cell／ul的患者其感染率明显增加。结论3个地区艾滋病慢性腹泻患者隐孢子虫感染率与性别无关；患者来自农村地区、CD4＋T淋巴细胞计数水平降低、疾病为中晚期患者易发生隐孢子虫感染。

Objective To investigate the Cryptosporidium infection and its epidemiological characteristics in HIV/AIDS patients with chronic diarrhea. Methods Stool samples collected from HIV/AIDS confirmed patients with chronic diarrhea who lived in Beijing, Henan and Xinjiang. Samples were concentrated by Formalin-Ethyl Acetate Sedimentation technique and stained by modified acid-fast stain （AFS） for the identification of oocysts by microscopy. CD4＋T cells count was performed by Flow Cytometry. Results The overall infection rate of Cryptosporidiurn in AIDS patients was 12.6% （32/253）. The infection rates of oocysts in the area of Beijing, Henan and Xinjiang were 5.97%（4/67）, 16.1%（24/149） and 10.8%（4/37） respectively. The infection rate of oocysts in the urban areas was 6.5% （7/104） while in the countryside it was 16.8% （25/149） and the difference was significantly different. However, there were no any differences discovered between the infection rates on patient＇ s gender or on infection occurred in different seasons. The infectious rates of ooeyst in patients on different stages of the disease were also significantly different （P〈0.01）. Conclusion AIDS patients infected by Cryptosporidium were not rarely seen in northern China. The rate of infection was not associated with patient＇ s gender but was associated with patient＇ s living environments. Patients living in the countryside, with lower lever of CD4 ＋ T cells counts and at the middle/late stage of the disease, Cryptosporidium infection appeared to be high.