118例AIDS病人支气管肺泡灌洗液的病原学检测分析

Pathogenic detection and analysis of bronchoalveolar lavage fluid in 118 AIDS patients

目的探讨纤维支气管镜及支气管肺泡灌洗对艾滋病(AIDS)病人肺部感染病原诊断的意义。方法回顾分析2016年5月至2017年10月杭州市西溪医院收治的118例患肺部感染的AIDS病人,行纤维支气管镜检查的临床资料,以及纤维支气管镜检查和支气管肺泡灌洗液(BALF)病原学检查结果。结果 118例AIDS合并肺部感染病人的BALF中,分枝杆菌抗酸染色阳性者22例,细菌培养阳性3例,耶氏肺孢子菌阳性27例,真菌培养阳性16例,巨细胞病毒阳性52例,半乳甘露聚糖阳性56例,其中考虑曲霉菌43例。结论 AIDS病人肺部感染的病原菌以巨细胞病毒、结核分枝杆菌、真菌及耶氏肺孢子菌为主。纤维支气管镜及支气管肺泡灌洗对AIDS病人肺部感染的病原学诊断有较高价值。

Objective To investigate the significance of fiberoptic bronchoscopy and bronchoalveolar lavage in the etiological diagnosis of pulmonary infection in AIDS patients.Methods Retrospective analysis was made based on clinical data,fiberoptic bronchoscopy and bronchoalveolar lavage fluid etiological examination results of the 118 AIDS patients with pulmonary infection from May 2016 to Oct 2017 hospitalized in Xixi hospital of Hangzhou.Results Among 118 patients,we found 22 cases of mycobacteri infection,3 cases of bacterial infection,27 cases of PCP,16 cases of fungal positive,52 cases of CMV,56 cases of GM positive.43 cases were considered as aspergillus.Conclusion The main pathogens of pulmonary infection in AIDS patients are cytomegalovirus,mycobacterium tuberculosis,fungi and pneumocystis carinii.Fiberoptic bronchoscopy and bronchoalveolar lavage are of high value in the etiological diagnosis of pulmonary infection in AIDS patients.