HIV/AIDS慢性腹泻患者149例隐孢子虫感染分析

Detection of Cryptosporidium Infection in 149 HIV/AIDS Patients with Chronic Diarrhea

目的分析HIV/AIDS慢性腹泻患者中隐孢子虫感染情况、感染因素及流行特点,为防治隐孢子虫在AIDS患者中的感染提供依据。方法从河南省上蔡县收集AIDS慢性腹泻患者粪便标本149份,采用甲醛-乙酸乙酰沉淀法对患者粪便标本进行集卵,用改良抗酸染色法进行染色检测隐孢子虫卵囊。同时检测患者血液中CD4+T细胞计数。结果 149例HIV/AIDS慢性腹泻患者的粪便标本中24例为隐孢子虫阳性,感染率为16.11%。男性与女性患者及各年龄组感染率比较差异无统计学意义(P均>0.05);HIV/AIDS患者处于HIV无症状期、有症状期和HIV/AIDS期的隐孢子虫感染率分别为0(0/7),25.81%(16/62)和9.88%(8/81),其差异有统计学意义(P<0.05);患者CD4+T细胞水平在<200cells/μL,201～499cells/μL和>500cells/μL的隐孢子虫感染率分别为22.00%(11/50),13.68%(13/95)和0(0/21),差异有统计学意义(P<0.05)。结论 HIV/AIDS慢性腹泻患者中存在着隐孢子虫感染,中晚期患者随着病情的进展,特别是随着CD4+T淋巴细胞水平的降低,感染的危险性明显增高。

Objective To investigate the infection of Cryptosporidium and its epidemicological characteristics in HIV/ AIDS patients with chronic diarrhea. Methods One hundred and forty-nine stool samples collected from H1V/AIDS confirmed patients with chroninc diarrhea who lived in Henan province. The 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 positive T lymphocyte count was detected by Flow Cytometry. Results The total infection rate of Cr/ptosporidium in HIV/AIDS patients was 16.11% （24/149）. There were no significant difference was found according to patient＇s gender and patient＇s age （P both 〉 0.05 ）. The infection rate was significantly higher in patients whose CD4 positive T lymphocyte count were low than that whose CD4 positive T lymphocyte count were high （ P 〈 0.05 ）. We ＇also found significant difference of infection rate among HIV/AIDS patients on different disease status （P 〈 0.05）. Conclusion HIV/AIDS patients with chronic diarrhea have the infection of Cryptosporidium. With the progress of the disease in the middle-late status of AIDS patients especially in patients who have low level of CD4 positive T lymphocyte count may have high risk of cryptosporidium infection.