Kirsch C M, Azzi R L, Yenokida G G, Jensen W A
Division of Respiratory Medicine, Santa Clara Valley Medical Center, San Jose, California 95128.
Am J Med Sci. 1990 Jun;299(6):386-91. doi: 10.1097/00000441-199006000-00006.
Sixty-two patients with possible AIDS-associated Pneumocystis carinii pneumonia (PCP) were studied to determine the diagnostic usefulness of sputum analysis and whether or not the results of sputum analysis are related to severity of disease. Induced sputum was stained with Gomori Methenamine silver and modified Wright Giemsa stains. Indicators of disease severity were: extent of chest roentgenographic infiltrate, serum lactic dehydrogenase activity, alveolar-arterial oxygen tension difference, and total blood lymphocyte count. All patients with sputum negative for Pneumocystis underwent bronchoscopy with bronchoalveolar lavage. Sputum analysis was 71% sensitive and 100% specific for the diagnosis of PCP. The negative predictive value of sputum analysis was 48%. There was no relationship between sputum results and the severity of PCP. This study led to the conclusions that sputum analysis is a sensitive, specific, rapid, and low-cost technique for the diagnosis of PCP, and that the sensitivity of sputum analysis for the detection of PCP is not affected by the severity of PCP.
对62例可能患有艾滋病相关卡氏肺孢子虫肺炎（PCP）的患者进行了研究，以确定痰液分析的诊断价值以及痰液分析结果是否与疾病严重程度相关。诱导痰液用改良的吉姆萨染色和Gomori甲胺银染色。疾病严重程度的指标包括：胸部X线浸润范围、血清乳酸脱氢酶活性、肺泡-动脉氧分压差和全血淋巴细胞计数。所有痰液中未检测到肺孢子虫的患者均接受了支气管镜下支气管肺泡灌洗。痰液分析对PCP诊断的敏感性为71%，特异性为100%。痰液分析的阴性预测值为48%。痰液结果与PCP严重程度之间无相关性。本研究得出结论，痰液分析是一种用于诊断PCP的敏感、特异、快速且低成本的技术，并且痰液分析检测PCP的敏感性不受PCP严重程度的影响。
