Chatterton J M, Joss A W, Williams H, Ho-Yen D O
Microbiology Department, Raigmore Hospital, Inverness, Scotland.
J Clin Pathol. 1989 Aug;42(8):865-8. doi: 10.1136/jcp.42.8.865.
Sera from blood donors and patients from all over Scotland were examined by indirect immunofluorescence using Pneumocystis carinii antigen from infected rat lung. Antibody was found in 76 of 488 (15.6%) of patients tested on clinical grounds but in only 13 of 148 (8.8%) blood donors. The antibody rates were higher in disease groups likely to have or develop P carinii pneumonia: in those with histologically confirmed or strongly suspected P carinii pneumonia the rate was 14 of 24 (58.3%); in those who had undergone transplantation eight of 24 (33.3%); in those who were immunosuppressed five of 16 (31.2%); in those who were human immunodeficiency virus antibody (HIV) positive 11 of 43 (25.6%); in those with malignancy 34 of 233 (14.6%); and in those with chest infection 10 of 85 (11.7%). P carinii pneumonia was confirmed or likely in four of 45 (8.8%) patients with titres of 1/8-1/16 and in three of seven (42.8%) in those with titres of greater than or equal to 1/128. Seroconversion or rising titre was detected in seven of 13 (53.8%) cases of confirmed or likely P carinii pneumonia compared with 10 of 93 (10.7%) in other patients. Diagnosis of P carinii infection can therefore be assisted by positive immunofluorescence results, but negative serology does not exclude infection.
使用来自感染大鼠肺的卡氏肺孢子虫抗原，通过间接免疫荧光法检测了来自苏格兰各地的献血者和患者的血清。根据临床理由检测的488名患者中有76名（15.6%）发现了抗体，但在148名献血者中只有13名（8.8%）发现了抗体。在可能患有或发展为卡氏肺孢子虫肺炎的疾病组中，抗体率更高：在组织学确诊或高度怀疑为卡氏肺孢子虫肺炎的患者中，抗体率为24名中的14名（58.3%）；在接受移植的患者中，24名中有8名（33.3%）；在免疫抑制患者中，16名中有5名（31.2%）；在人类免疫缺陷病毒抗体（HIV）阳性患者中，43名中有11名（25.6%）；在患有恶性肿瘤的患者中，233名中有34名（14.6%）；在患有胸部感染的患者中，85名中有10名（11.7%）。在45名滴度为1/8 - 1/16的患者中有4名（8.8%）确诊或可能患有卡氏肺孢子虫肺炎，在7名滴度大于或等于1/128的患者中有3名（42.8%）确诊或可能患有卡氏肺孢子虫肺炎。在确诊或可能患有卡氏肺孢子虫肺炎的13例病例中有7例（53.8%）检测到血清转化或滴度升高，而在其他患者中93例中有10例（10.7%）检测到血清转化或滴度升高。因此，阳性免疫荧光结果有助于卡氏肺孢子虫感染的诊断，但血清学阴性并不能排除感染。
