O'Brien R F, Quinn J L, Miyahara B T, Lepoff R B, Cohn D L
Department of Medicine, (Pulmonary and Infectious Disease Divisions), Denver General Hospital, University of Colorado Health Sciences Center.
Chest. 1989 Jan;95(1):136-8. doi: 10.1378/chest.95.1.136.
Examination of induced sputum from AIDS patients has been reported to provide the noninvasive diagnosis of PCP in 10 to 76 percent of cases. Since previous studies were done in centers with a high incidence of AIDS, we asked whether this test could be implemented successfully in a center with a lower incidence of AIDS. Over a 13-month period 25 of 38 (66 percent) AIDS patients with PCP had positive Giemsa (Diff-Quik) stains of induced sputum. We were unable to predict before sputum induction which patients would be positive based on clinical severity (increased A-a gradient or serum LDH levels). We confirmed prior observations that a normal serum LDH level was found in only 5 percent of documented PCP cases. This noninvasive technique significantly decreased the number of bronchoscopies performed and led to a considerable cost savings.
据报道，对艾滋病患者诱导痰进行检查可在10%至76%的病例中实现对肺孢子菌肺炎（PCP）的无创诊断。由于之前的研究是在艾滋病高发中心进行的，我们想了解这项检测在艾滋病发病率较低的中心是否能成功实施。在13个月的时间里，38例患有PCP的艾滋病患者中有25例（66%）诱导痰吉姆萨（Diff - Quik）染色呈阳性。在诱导痰之前，我们无法根据临床严重程度（肺泡 - 动脉血氧分压差增加或血清乳酸脱氢酶水平升高）预测哪些患者会呈阳性。我们证实了之前的观察结果，即仅5%的已记录PCP病例血清乳酸脱氢酶水平正常。这项无创技术显著减少了支气管镜检查的次数，并节省了可观的费用。
