荧光染色技术在艾滋病患者活检标本病原学诊断中的应用

Application of fluorescence technique in the biopsy etiologic diagnosis for AIDS patients

目的探讨快速真菌与抗酸分枝杆菌荧光技术在艾滋病患者活检标本病原体诊断中的应用价值及意义。方法选取艾滋病患者500例活检标本,采用快速真菌荧光染色及六胺银、PAS染色对300例可疑真菌感染的活检标本进行检测,采用抗酸分枝杆菌荧光染色及萋尼抗酸染色对200例可疑结核的活检标本进行检测,并对检测结果进行对比。结果(1)快速真菌荧光镜检法检出阳性205例(阳性率68.3%),六胺银染色法检出阳性209例(阳性率69.7%),PAS染色法检出阳性97例(阳性率39.5%),快速真菌荧光染色与六胺银染色检出阳性率差异无统计学意义(P>0.05),但高于PAS染色法;(2)抗酸分枝杆菌荧光染色检出阳性179例(阳性率89.5%),萋尼抗酸染色法检出阳性117例(阳性率58.5%),抗酸分枝杆菌荧光染色阳性率高于萋尼抗酸染色法,两者差异有统计学意义(P<0.01);(3)荧光染色比常规特殊染色操作更快速、简便、显示更清晰。结论艾滋病患者并发机会性感染病原体种类多样,普通的特殊染色阳性率不高并且费时费力,而快速真菌及抗酸荧光染色特别是抗酸荧光染色的阳性率明显增高,为活检组织诊断真菌及结核分枝杆菌感染提供一种快速、准确、经济、对比更清晰的染色方法,能够为真菌感染及结核病患者诊断提供可靠的指导依据,值得在病原体诊断工作中广泛使用。

Objective To evaluate the application and significance of rapid fungal and acid resistant Mycobacteri-um fluorescence technique in biopsy etiologic diagnosis for AIDS.Methods Five-hundred biopsies of AIDS patients were selected,and 300 biopsies of suspected fungal infection were collected.Rapid fungal staining,Gomori's methenamine silver staining and PAS staining were performed on all subjects.Anti-acid Mycobacterium fluorescence staining and Ziehi-Neelsen anti acid staining were performed on 200 biopsies of suspected tuberculosis infection cases.Results Totally 205 cases(68.3%)were positive by rapid fungal fluorescence microscopy;209 cases(69.7%)were positive by hexamine silver staining and 97 cases(39.5%)were positive by PAS staining.There was no significant difference in the positive rate between fast fungal fluorescent staining and hexamine silver staining,but they were both higher than that of PAS staining.Totally 179 cases(89.5%)were positive in acid fast Mycobacterium staining;117(58.5%)were positive in Zini acid fast Mycobacterium staining;and the positive rate of acid fast Mycobacterium staining was significantly higher than that of Zini acid fast Mycobacterium staining(P<0.01).Conclusion There are many kinds of pathogens in AIDS patients with opportunistic infection.The positive rate of common special staining is not high and time-consuming;while the positive rate of fast fungal and anti-acid fluorescent staining,especially anti acid fluorescent staining,is significantly higher.It can provide a fast,accurate,economic and clear staining method for the diagnosis of fungal and Mycobacterium tuberculosis infection in biopsy tissues,providing reliable guidance for the diagnosis of fungi infection and tuberculosis.