Carstens J, Andersen P L
Dept of Infectious Diseases, Marselisborg Hospital, Aarhus, Denmark.
Eur Respir J. 1994 Jul;7(7):1233-8. doi: 10.1183/09031936.94.07071233.
Our aim was to investigate whether serum neopterin and beta 2-microglobulin have any value in the distinction between Pneumocystis carinii pneumonia (PCP) and pneumonia due to extracellular bacteria. Also, to study whether neopterin and beta 2-microglobulin would correlate with the clinical course of lung infections in human immunodeficiency virus (HIV)-positive and HIV-negative patients. Thirty HIV-positive subjects with PCP, 9 HIV-positive patients with bacterial pneumonia, and 16 HIV-negative patients with bacterial pneumonia were investigated. Thirty eight asymptomatic HIV-positive subjects and 48 healthy blood donors were used as controls. The HIV-positive patients with PCP and the HIV-positive subjects with bacterial pneumonia had significantly and similarly elevated levels of neopterin and beta 2-microglobulin in the acute stage. In the weeks before the acute stage of PCP, neopterin and beta 2-microglobulin had been increasing. After start of treatment, serum neopterin declined significantly, whilst serum beta 2-microglobulin remained elevated. The HIV-negative patients with bacterial pneumonia had significantly increased serum concentrations of both markers in the acute stage, and had decreasing serum concentrations in the weeks after treatment. We conclude that neither neopterin nor beta 2-microglobulin seem to be of value in distinction between PCP and bacterial pneumonia in HIV-positive subjects. In the HIV-positive patients, neopterin may correlate partly with the clinical activity of PCP, whilst serum beta 2-microglobulin may remain elevated after PCP, despite treatment and recovery. The elevated level may, in part, be due to repeated infections and progression to acquired immune deficiency syndrome (AIDS).(ABSTRACT TRUNCATED AT 250 WORDS)
我们的目的是研究血清新蝶呤和β2-微球蛋白在区分卡氏肺孢子虫肺炎（PCP）和细胞外细菌所致肺炎方面是否具有任何价值。此外，研究新蝶呤和β2-微球蛋白是否与人类免疫缺陷病毒（HIV）阳性和HIV阴性患者肺部感染的临床病程相关。对30例患有PCP的HIV阳性受试者、9例患有细菌性肺炎的HIV阳性患者以及16例患有细菌性肺炎的HIV阴性患者进行了研究。38例无症状HIV阳性受试者和48名健康献血者作为对照。患有PCP的HIV阳性患者和患有细菌性肺炎的HIV阳性受试者在急性期新蝶呤和β2-微球蛋白水平均显著且相似地升高。在PCP急性期前的几周，新蝶呤和β2-微球蛋白一直在升高。开始治疗后，血清新蝶呤显著下降，而血清β2-微球蛋白仍保持升高。患有细菌性肺炎的HIV阴性患者在急性期两种标志物的血清浓度均显著升高，治疗后几周血清浓度下降。我们得出结论，新蝶呤和β2-微球蛋白在区分HIV阳性受试者的PCP和细菌性肺炎方面似乎均无价值。在HIV阳性患者中，新蝶呤可能部分与PCP的临床活动相关，而血清β2-微球蛋白在PCP后可能尽管经过治疗和康复仍保持升高。升高的水平可能部分归因于反复感染和进展为获得性免疫缺陷综合征（AIDS）。（摘要截短于250字）
