【摘要】 ①目的探讨卡氏肺孢子虫的检测方法及感染状况。②方法收取病人痰液、肺组织及支气管灌洗液，常规方法提取ＤＮＡ，用聚合酶链反应（ＰＣＲ）技术检测卡氏肺孢子虫ＤＮＡ，并与吉氏染色结果进行比较。③结果８６例住院病人，卡氏肺孢子虫ＤＮＡ的ＰＣＲ检出率为４１．９％，卡氏肺孢子虫包囊吉氏染色法的检出率为１４．９％，两种方法的检出率比较，差异有显著性（ｕ＝６．６３８，Ｐ＜０．０５）。尿毒症、肺癌、血液病和肺部炎症病人卡氏肺孢子虫ＤＮＡ的ＰＣＲ检出率分别为３７．５％，６１．５％，５０．０％和２０．８％，差异有显著性（χ２＝９．０１，Ｐ＜０．０５）。痰液、肺组织和支气管灌洗液标本，卡氏肺孢子虫ＤＮＡＰＣＲ的检出率分别为２８．６％，６１．９％和７７．８％，差异有极显著意义（χ２＝１２．３０，Ｐ＜０．０１）。吉氏染色法检测出的１０份卡氏肺孢子虫包囊阳性标本，ＰＣＲ检测皆为阳性；５７份阴性标本，ＰＣＲ检测出１５份为阳性。４份结核标本ＰＣＲ检测皆为阴性。④结论ＰＣＲ技术检测肺组织和支气管灌洗液标本中的卡氏肺孢子虫ＤＮＡ，具有较高的敏感性和特异性更多还原

【Abstract】 Objective To study the detection methods and infection rate of pneumocystis carinii (P.carinii) in inpatients. Methods The sputum, lung tissue and bronchoalveolar lavage(BAL) were obtained from inpatients. DNA were extracted with standard methods and amplified by PCR technique. The amplified PCR product was detected by AGE. The positive rate was compared with that of Giemsa staining. Results The positive rate of P. carinii DNA detected by PCR technique in 86 hospitalized patients was 41.9%, while the positive rate by Giemsa staining was 14.9%. The difference between the two methods was significant( u=6.638, P< 0. 05) . The positive rates of P. carinii by PCR in patients of uremia, pulmonary carcinoma, hematopathy and pulmonary inflammation were 37.5%, 61.5%,50% and 20. 8% respectively. The differences among different diseases were significant( χ 2=9.01, P <0.05). The positive rate of P.carinii DNA by PCR in sputum, lung tissue and BAL were 28. 6%, 61. 9% and 77.8% respectively. The differences between different samples were significant( χ 2=12.3, P <0.01). Of the 57 negative samples detected by Giemsa staining, 15 samples were further confirmed positive by PCR.The 10 positive samples by Giemsa staining showed positivity by PCR as well. PCR examination showed negative results for the 4 tuberculosis samples. Conclusion PCR technique has higher sensitivity and specificity in the detection of P. carinii DNA in lung tissue and BAL samples.更多还原