艾滋病合并卡氏肺孢子虫肺炎1996例分析

Cfinical analysis of pneumocystis carinfi infection of 1 996 cases of HIV/AIDS patients

目的探讨卡氏肺孢子虫肺炎（PCP）的临床特点，以及CD4＋淋巴细胞变化。方法采用姬姆萨染色法染色肺孢子虫（PC），结合流式细胞法检测CD4＋淋巴细胞，统计分析Pc总阳性率、年均阳性率、月均阳性率、性别人群阳性率，以及痰液与支气管肺泡灌洗液、co；淋巴细胞与PC阳性率等关系。结果1806份痰标本总阳性率为46．8％，每年4月、5月、6月、7月是检出率高峰期，男性和女性人群阳性率分别为46．3％和50．2％。年均阳性率差异无统计学意义（P〉0．05），月均差异有统计学意义（P〈0．05），并有季节性；痰液与灌洗液间阳性率差异有统计学意义（P〈0．05），不同CD4＋范围PC阳性率差异有统计学意义（P〈0．05）。结论艾滋病患者痰液PC姬姆萨染色法总阳性率46．8％，但一年之中有固定的季节波动，支气管肺泡灌洗液阳性率高于痰液，CD4＋淋巴细胞数量越少阳性率越高。

Objective To investigate the infection status of HIV/AIDS patients complicated with pneumocystis Carinii Poneumonia（PCP） ,and the role of CD4T lymphocyte in PCP. Methods PC was detected by Giemsa＇s staining and CD4＋ T lymphocyte was counted by flow cytometry. Meanwhile,this text calculated and compared a series of indexes about PC infection, such as the total positive rate, the average annual positive rate, the average monthly positive rate,the positive rate between female and male,the positive rate between sputum and BALF specimens, and the relationship between the positive rate and CD4＋ T lymphocyte count. Results The total positive rate about PC infection of the 1 806 cases of sputum specimens was 46. 8% ,and the incidence mainly from April to July during a year,and the positive rates were 46.3% and 50.2% for males and females respectively. The results showed that there were no Significant differences when compared with the average annual positive rate （ P 〉 0.05 ）, but there were significant differences when compared with the average monthly positive rate （ P 〈 0.05 ）, the positive rate between female and male（P〉0.05） ,and among 3 formerly defined ranges of CD4＋ count（P 〈0.05）. Conclusion Giemsa＇s staining showed the total positive rate was 46, 8% of the HIV/AIDS patients infected by PC with sputum specimens, which represented a seasonal fluctuation tendency. The positive rate of BALF was higher than that in sputum,and it increased with CD4＋ count decreasing. Giemsa＇s staining was an efficient,simple and feasible way for PC detection and easy for generalization. Meanwhile,it is strongly relied on the operator＇s experience and skill.