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肺隐球菌病:免疫功能正常和免疫功能低下患者中隐球菌抗原检测与影像学的比较。

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients.

机构信息

Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.

Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

出版信息

BMC Infect Dis. 2020 Jan 30;20(1):91. doi: 10.1186/s12879-020-4818-1.

Abstract

BACKGROUND

We compared the cryptococcal antigen detection and imaging findings between immunocompetent and immunocompromised patients in whom pulmonary cryptococcosis had been diagnosed. The aim of our study was to determine whether the patient's immune status and radiography affect the detection of cryptococcal antigen.

METHODS

According to whether they took immunosuppressive drugs or not, seventy and eight adult patients with pulmonary cryptococcosis were divided into two groups: the immunocompetent group and the immunocompromised group. According to the detection of CrAg, each group was divided into the CrAg+ group and the CrAg- group. Then, clinical records, laboratory examinations and computed tomography findings were collected and analyzed.

RESULTS

No difference was found in baseline characteristics, clinical symptoms, and laboratory investigations. By comparing CrAg detection in these two groups, it was found that the number of CrAg+ cases in the immunocompetent group was more than that in the immunocompromised group. And in the immunocompetent group, diffuse lesions were more common in CrAg+ group and limited lesions were more frequently observed in CrAg- group.

CONCLUSIONS

The patient's immune status and radiography would affect the detection of cryptococcal antigen. And serum CrAg could be a useful tool for the diagnosis of pulmonary cryptococcosis in immunocompetent patients with extensive lung involvement.

摘要

背景

我们比较了免疫功能正常和免疫功能低下的肺部隐球菌病患者的隐球菌抗原检测和影像学表现。我们的研究目的是确定患者的免疫状态和影像学是否会影响隐球菌抗原的检测。

方法

根据是否使用免疫抑制剂,将 70 例和 8 例成人肺部隐球菌病患者分为免疫功能正常组和免疫功能低下组。根据 CrAg 的检测结果,将每组分为 CrAg+组和 CrAg-组。然后收集并分析临床记录、实验室检查和计算机断层扫描结果。

结果

两组患者的基线特征、临床症状和实验室检查均无差异。通过比较两组的 CrAg 检测结果,发现免疫功能正常组的 CrAg+病例数多于免疫功能低下组。在免疫功能正常组中,CrAg+组更常见弥漫性病变,CrAg-组更常见局限性病变。

结论

患者的免疫状态和影像学表现会影响隐球菌抗原的检测。血清 CrAg 可作为广泛肺部受累的免疫功能正常的肺部隐球菌病患者的一种有用的诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd82/6993350/b1257bcd4116/12879_2020_4818_Fig1_HTML.jpg

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