摘要
目的分析云南地区近5年HIV/AIDS患者合并深部真菌感染的类型与免疫学特征。方法采集住院HIV/AIDS患者送检血液、脑脊液、骨髓、痰及脓液等标本进行菌种的培养及鉴定,用流式细胞技术检测合并深部真菌感染的HIV患者外周血T淋巴细胞亚群。结果 645例合并深部真菌感染的HIV/AIDS中分离出菌株702株,共11种,包括念珠菌304株(占43.3%),马尔尼菲篮状菌231株(占32.91%),新型隐球菌151株(占21.51%)。不同感染类型患者的CD4^+T淋巴细胞水平比较差异有统计学意义(χ^2=77.414,P<0.01)。合并马尔尼菲篮状菌和新型隐球菌感染者的CD8^+T淋巴细胞水平比较差异有统计学意义(χ^2=33.624,P<0.01)、马尔尼菲篮状菌与念珠菌感染的患者CD8^+T淋巴细胞水平比较差异有统计学意义(χ^2=13.161,P<0.01)。HIV/AIDS患者合并感染真菌种类与CD4^+T/CD8^+T水平具有相关关系(χ^2=45.013,P<0.01)。结论 HIV/AIDS患者易合并深部真菌感染,且不同菌种感染者的T淋巴细胞亚群构成不同。应根据艾滋病患者CD4^+、CD8^+ T淋巴细胞计数及CD4^+T/CD8^+T比值变化,进行治疗以降低病死率。
Objective To analyze the types and immunological characteristics of deep fungal infections in patients with HIV/AIDS in Yunnan for the past 5 years.Methods Samples of blood,cerebrospinal fluid,bone marrow,sputum,and pus were collected from inpatients with HIV/AIDS for culture and identification.Peripheral blood T lymphocyte subsets in patients with HIV and a deep fungal infection were detected using flow cytometry.Results A total of 702 strains of fungi were isolated from patients with HIV/AIDS,including 304 strains(43.3%)of Candida,231 strains(32.91%)of Talaromyces marneffei,and 151 strains(21.51%)of Cryptococcus neoformans.There were significant differences in CD4^+T lymphocyte levels between patients with different types of infection(χ^2=77.414,P<0.01).There were significant differences in CD8^+T lymphocyte levels between patients infected with T.marneffei and those infected with C.neof ormans(χ^2=33,624,P<0.01).There were significant differences in CD8^+T lymphocyte levels between patients infected with T.marneffei and those infected with Candida(χ^2=13.161,P<0.01).There was a correlation between the number of fungal infections in patients with HIV/AIDS and the level of CD4^+T/CD8^+T cells(χ^2=45.013,P<0.01).Conclusion Patients with HIV/AIDS are prone to developing a deep fungal infection,and T lymphocyte subsets differ with different fungal strains.Treatment should be based on changes in CD4^+T,CD8^+T lymphocyte counts and CD4^+T/CD8^+T ratios in patients with AIDS to reduce mortality.
作者
孙艾丝
刘家法
张米
李健健
李正伦
杨壁珲
董兴齐
SUN Ai-si;LIU Jia-fa;ZHANG Mi;LI Jian-jian;LI Zheng-lun;YANG Bi-hui;DONG Xing-qi(The Infectious Disease Hospital of Yunnan Province,Yunnan Provincial AIDS Care Center,Kunming,China 650301;Dali University)
出处
《中国病原生物学杂志》
CSCD
北大核心
2020年第1期42-46,51,共6页
Journal of Pathogen Biology
基金
"十三五国家科技重大专项"项目(No.2018ZX10721102-002)
云南省教育厅科学研究基金项目(No.2018JS252)
云南省医疗卫生单位内设研究机构项目(No.2017NS124)。
