HIV/AIDS合并隐球菌性脑膜炎患者治疗过程中不同隐球菌检测方法的比较

Comparison of different detection methods in the treatment of HIV/AIDS patients with cryptococcal meningitis

目的分析艾滋病合并隐球菌性脑膜炎患者在治疗过程中不同隐球菌检测方法结果的变化并比较它们的差异。方法回顾性分析22例艾滋病合并隐球菌性脑膜炎患者的临床资料。在5个治疗时间段内(0 d、1周、2周、1个月、2个月)采用培养法、墨汁染色法和胶体金免疫层析法分别检测脑脊液中的隐球菌或隐球菌抗原,观察不同方法在不同时间段的差异。结果培养法每个阶段阳性率分别为95.45%、90.90%、81.82%、45.45%和4.55%,墨汁染色法阳性率分别为100.00%、100.00%、95.45、90.91%和72.73%,胶体金免疫层析法阳性率均为100.00%。在治疗1个月后,除墨汁染色法与胶体金免疫层析法差异无统计学意义(P> 0.05)外,其余各方法之间差异均有统计学意义(P <0.05)。结论墨汁染色法和胶体金免疫层析法适用于隐球菌感染的早期诊断,且胶体金免疫层析法持续阳性时间较长,培养法阳性率随治疗进程显著下降,更适用于阶段性治疗。

Objective To analyze the changes of different detection methods in the treatment of AIDS patients with cryptococcal meningitis and to compare their differences. Methods Clinical data of 22 AIDS patients with cryptococcal meningitis were analyzed retrospectively. In 5 treatment periods( 0 d,1 week,2 weeks,1 month and 2 months),cryptococcal or cryptococcal antigen in CSF was detected by culture method,ink staining method and colloidal gold immunochromatography,and the difference of different methods in different periods was observed. Results The positive rates of culture method at each stage were 95. 45%,90. 90%,81. 82%,45. 45% and 4. 55%. The positive rates of ink staining method were 100. 00%,100. 00%,95. 45%,90. 91% and 72. 73%. The positive rates of colloidal gold immunochromatography method were100. 00%. After 1 month of treatment,there was no statistical significance on the difference between ink staining and gold immunochromatography( P > 0. 05),but the differences among other methods were statistically significant( P < 0. 05).Conclusion Ink staining and colloidal gold immunochromatography are suitable for the early diagnosis of cryptococcal infection,and colloidal gold immuneeeochromatography lasts for long time. The positive rate of culture method decreases significantly with the progress of treatment,which is more suitable for stage treatment.