Shimomoto H, Hasegawa Y, Takagi N, Ichiyama S, Takamatsu J, Saito H, Shimokata K
First Department of Internal Medicine, Nagoya University School of Medicine.
Intern Med. 1995 Oct;34(10):976-81. doi: 10.2169/internalmedicine.34.976.
The purpose of this study was to diagnose the initial stage of acute pulmonary infections due to Pneumocystis carinii (P. carinii), Mycobacterium tuberculosis (M. tuberculosis), and cytomegalovirus (CMV) by polymerase chain reaction (PCR) combined with the induced sputum method in hemophilia patients infected with human immunodeficiency virus (HIV). Induced sputum and PCR were obtained at each outpatient visit or when any respiratory symptoms were present during a one-year period. All patients with a CD4+ count of less than 200 x 10(6)/l were given prophylactics against P. carinii pneumonia (PCP). PCR was conducted 111 times in 29 patients. M. tuberculosis DNA was detected in 1 patient and CMV DNA in 4 patients. P. carinii DNA was not detected. PCR on induced sputum samples is sensitive for the rapid detection of the initial stage of respiratory events. PCP prophylaxis changes the clinical manifestations of HIV infection.
本研究的目的是通过聚合酶链反应（PCR）结合诱导痰法，对感染人类免疫缺陷病毒（HIV）的血友病患者中卡氏肺孢子虫（P. carinii）、结核分枝杆菌（M. tuberculosis）和巨细胞病毒（CMV）引起的急性肺部感染的初始阶段进行诊断。在为期一年的时间里，每次门诊就诊时或出现任何呼吸道症状时采集诱导痰并进行PCR检测。所有CD4 +细胞计数低于200×10(6)/l的患者均接受了卡氏肺孢子虫肺炎（PCP）的预防性治疗。对29例患者进行了111次PCR检测。在1例患者中检测到结核分枝杆菌DNA，4例患者中检测到CMV DNA。未检测到卡氏肺孢子虫DNA。对诱导痰样本进行PCR检测对快速检测呼吸道疾病的初始阶段很敏感。PCP预防性治疗改变了HIV感染的临床表现。
