艾滋病合并肺部感染患者支气管镜活检组织的病理学特征

发布时间：2018-06-30 07:51

本文选题：获得性免疫缺陷综合征 + 肺部感染　；参考：《临床与实验病理学杂志》2017年05期

【摘要】：目的探讨艾滋病合并肺部感染患者支气管镜活检组织的病理学特征,了解引起肺部机会性感染的病原体种类。方法收集临床确诊为艾滋病并有肺部感染患者1 386例,行支气管镜检查并获取活检标本,采用HE染色、特殊染色(六胺银、PAS、抗酸染色)及免疫组化SP法染色,分析支气管镜活检组织的病理学特征,确诊肺部机会性感染的病原体。结果支气管镜病变主要表现为黏膜慢性炎症,1 386例艾滋病患者中,693例(50%)查出特异性病原体(部分病例为2种或2种以上病原体重复感染),其中肺孢子菌感染246例(17.7%),分枝杆菌感染147例(10.6%),巨细胞病毒感染136例(9.8%),马尔尼菲青霉菌感染83例(6%),隐球菌感染72例(5.2%),白色假丝酵母菌、曲霉菌及毛霉菌感染合计18例(1.3%),及未能确定类型的真菌感染80例(5.8%)。结论艾滋病患者的支气管镜病变以慢性炎症多见,支气管镜活检病理检查能在一定程度上明确机会性感染的病原体。
[Abstract]:Objective to investigate the histopathological features of bronchoscopic biopsy in patients with AIDS complicated with pulmonary infection and to understand the pathogens causing opportunistic pulmonary infection. Methods A total of 1 386 patients with clinically diagnosed AIDS and pulmonary infection were examined by bronchoscopy and biopsy specimens were obtained. The specimens were stained by HE staining, special staining (HPA, acid fast staining) and immunohistochemical SP staining. To analyze the pathological features of bronchoscopic biopsy tissue and to diagnose the pathogen of pulmonary opportunistic infection. Results among the 1 386 patients with chronic inflammation of mucous membrane, 693 (50%) were found with specific pathogens (some of which were superinfection of 2 or more pathogens), 246 of which were infected by Pneumocystis. There were 147 cases (10.6%) of mycobacterium infection, 136 cases (9.8%) of cytomegalovirus infection, 83 cases (6%) of Penicillium marneffei infection, 72 cases (5.2%) of Cryptococcus infection, and 2 cases (5.2%) of Candida albicans. 18 cases (1.3%) were infected with Aspergillus and Mucor, and 80 cases (5.8%) could not be identified. Conclusion chronic inflammation is more common in patients with AIDS. Bronchoscopic biopsy can identify the pathogen of opportunistic infection to some extent.
【作者单位】：广州市第八人民医院病理科;广州市第八人民医院感染科;广州市第八人民医院ICU;
【基金】：广州市医药卫生科技一般引导项目(20141A010032)
【分类号】：R512.91;R563.1

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