昆明市西山区2009年人群4种免疫抗体水平的监测分析

为了解昆明市西山区2009年健康人群中麻疹IgG、白喉IgG、乙肝表面抗原、乙肝表面抗体、乙脑IgG的免疫水平,评价预防接种效果,按卫生部《预防接种工作规范》(2005年版)人群免疫水平监测方法开展了调查。结果显示,白喉抗体总阳性率57.67%,1～4岁组白喉抗体阳性率为89.71%,白喉疫苗在计划免疫人群中实施效果较好,其它人群未能达到免疫成功率;麻疹抗体总阳性率69.71%,未能达到保护水平,而1～6岁组麻疹抗体阳性率为88.10%,达到计划免疫规程人群抗体阳性率85%的指标;乙肝表面抗原阳性率1.57%,乙肝抗体阳性率75.55%,但1～6岁组抗体阳性率较高,然后随年龄增加而降低;乙脑全人群抗体阳性率为70.53%,经过多次乙脑强化免疫,在人群中构建了较为有效的免疫屏障。西山区四种疫苗预防接种工作在国家免费所针对人群中实施效果较好,学龄前人群抗体阳性率较高,除乙脑疫苗接种人群外其它人群因未开展加强免疫工作,未能形成有效抗体免疫屏障,需定期开展重点人群强化免疫工作。     

儿童传染性单核细胞增多症嗜异性凝集抗体与EBV-VCA-IgM检测的比较

目的比较分析外周血异型淋巴细胞（AL）、血清嗜异性抗体（HA）及EBV-VCA-IgM在儿童传染性单核细胞增多症（IM）诊断中的意义。方法对238例儿童IM进行AL计数、AVITEX-IM乳胶凝集法检测HA、ELISA法检测EBV-VCA-IgM,分析比较此3种检验方法的阳性率。结果（1）82．35％的患儿外周血AL〉10％,其中71．94％在病程第2周AL〉10％。（2）HA阳性者占48．85％,HA阳性率〈3岁（14．55％）明显低于≥3岁（53．90％）,P〈0．05。（3）EBV-VCA-IgM 163例阳性（75．81％）,各年龄组EBV-VCA-IgM阳性率差异无显著性。（4）72例同时检测血清EBV-VCA-IgM和HA,EBV-VCA-IgM阳性者58例（80．56％）,HA阳性者36例（50％）,EBV-VCA-IgM与HA均为阳性者33例（45．83％）,EBV-VCA-IgM的阳性检出率明显高于HA。结论EBV-VCA-IgM的阳件率明昂高干HA的阳件塞罩期殛时拱奉台EBV抗体对于及早、快速、准确诊断IM十分必要。     

ROR2在骨肉瘤细胞和组织中的表达及其意义

目的：研究ROR2在骨肉瘤细胞及组织中的表达情况,探讨其表达的临床意义。方法：使用Western-blotting实验方法检测骨肉瘤及骨软骨瘤新鲜原发灶标本中ROR2表达情况;使用免疫组化方法检测骨肉瘤及骨软骨瘤原发灶标本中ROR2表达情况并结合临床资料了解其临床意义;使用RT-PCR实验方法检验SaoS-2骨肉瘤细胞中ROR2mRNA表达情况。结果：①通过免疫组织化学的方法检测骨肉瘤标本ROR2阳性表达率为70.91%,骨软骨瘤标本ROR2阳性表达率为20.00%,两者阳性表达率有显著性差异（x2=12.73 P〈0.05）。②Western-blotting实验检测新鲜骨软骨瘤和新鲜骨肉瘤组织中ROR2蛋白表达有显著性差异（P〈0.05）。③RT-PCR实验检测SaoS-2骨肉瘤细胞株中ROR2基因表达阳性。④检测在有转移的骨肉瘤患者标本中ROR2的阳性表达率为100.00%,在无肿瘤转移患者标本中阳性表达率为61.91%,两者表达阳性率有显著性差异（x2=5.26 P〈0.05）。⑤ROR2在骨肉瘤Enneking分期Ⅰ期表达阳性率为22.22%（2/9）,Ⅱ期表达阳性率为72.73%（24/33）,Ⅲ期表达阳性率为100.00%（13/13）。Ⅰ期与Ⅱ期间有显著性差异（x2=5.66 P〈0.05）,Ⅰ期与Ⅲ期间有显著性差异（x2=11.46 P〈0.05）,而Ⅱ期与Ⅲ期间无显著性差异（x2=2.85 P〉0.05）。结论：ROR2蛋白和基因在骨肉瘤组织及细胞中有较强表达。鉴于ROR2对于骨骼发育的影响及其通过WNT信号通路调节成骨细胞增殖及分化的生物学特点使得我们怀疑ROR2可能在骨肉瘤的发生发展过程中具有一定的作用,其可能促进了骨肉瘤的发生发展及恶性生物学行为。     

Detection of benign or malignant origin of ascites with combined indirect immunoperoxidase assays of carcinoembryonic antigen and lysozyme

The indirect immunoperoxidase method was used to study the presence of the intracellular carcinoembryonic antigen (CEA) and lysozyme (LZ) in alcohol-fixed cytologic smears of peritoneal fluids from 2 patients with chronic active hepatitis, 31 patients with liver cirrhosis and 7 patients with malignant liver disease. In the two patients with hepatitis, LZ was positive in both CEA was positive in one and negative in the other. Of the 31 patients with liver cirrhosis, 21 (67.5%) were LZ positive, 27 (87%) were CEA negative and only 4 (13%) were CEA positive. Of the seven patients with malignant disease, six were CEA positive and six were LZ negative. It is of interest that 23 of 24 (96%) LZ-positive results and 28 of 29 (97%) CEA-negative results corresponded to negative cytologic diagnoses for malignancy. Cytologic diagnosis of "reactive mesothelial cells" seemed to correlate better (71%) with CEA-negative and LZ-positive results. The data suggest that the investigation of CEA and LZ in the cells of peritoneal fluids appears to have promise as an adjunct to cytology in differentiating benign from malignant origins of the fluid.     

危重患者感染病原菌的分布及血清降钙素原水平的研究

目的 探讨危重患者感染病原菌的分布及血清降钙素原（PCT）的水平,为临床诊断与治疗提供依据。方法 对167例ICU危重感染患者同时送检的微生物培养和PCT检测的结果进行分析,比较两者间的关系。将微生物培养结果分为阴性组、单一标本阳性组、两种标本阳性组和三种及以上标本阳性组,进一步比较四组间PCT检测结果的差异并分析革兰阴性菌、革兰阳性菌和真菌感染后患者体内PCT的水平。结果 167例危重感染患者微生物培养阳性102例,阳性率为61.1%。PCT检测阳性103例,阳性率为61.7%。两者间无统计学差异（χ2=0.01,P>0.05）。两者联合检测的总阳性率为79.6%。102例微生物培养阳性患者中,PCT为0.57（0.10~131.50）μg/L,高于培养阴性患者[PCT为0.33（0.10~21.85）μg/L,U=8.52,P<0.05]。培养阳性患者中,单一标本阳性的PCT水平相对较低,两种及以上标本阳性的PCT水平相对较高。革兰阴性菌、革兰阳性菌和真菌感染组PCT阳性率分别为70.0%、64.7%和66.7%,混合感染组最高,为87.5%。结论 PCT可用于危重患者感染性疾病的早期预测。加强微生物培养和PCT的联合检测,可促进危重患者感染后的精准诊治。     

Frequency of False Positive Rapid HIV Serologic Tests in African Men and Women Receiving PrEP for HIV Prevention: Implications for Programmatic Roll-Out of Biomedical Interventions

Background

Rapid HIV assays are the mainstay of HIV testing globally. Delivery of effective biomedical HIV prevention strategies such as antiretroviral pre-exposure prophylaxis (PrEP) requires periodic HIV testing. Because rapid tests have high (>95%) but imperfect specificity, they are expected to generate some false positive results.

Methods

We assessed the frequency of true and false positive rapid results in the Partners PrEP Study, a randomized, placebo-controlled trial of PrEP. HIV testing was performed monthly using 2 rapid tests done in parallel with HIV enzyme immunoassay (EIA) confirmation following all positive rapid tests.

Results

A total of 99,009 monthly HIV tests were performed; 98,743 (99.7%) were dual-rapid HIV negative. Of the 266 visits with ≥1 positive rapid result, 99 (37.2%) had confirmatory positive EIA results (true positives), 155 (58.3%) had negative EIA results (false positives), and 12 (4.5%) had discordant EIA results. In the active PrEP arms, over two-thirds of visits with positive rapid test results were false positive results (69.2%, 110 of 159), although false positive results occurred at <1% (110/65,945) of total visits.

Conclusions

When HIV prevalence or incidence is low due to effective HIV prevention interventions, rapid HIV tests result in a high number of false relative to true positive results, although the absolute number of false results will be low. Program roll-out for effective interventions should plan for quality assurance of HIV testing, mechanisms for confirmatory HIV testing, and counseling strategies for persons with positive rapid test results.     

乳腺癌p53蛋白过度表达和雌激素受体免疫组化检测及意义

应用免疫组化方法,对３２例乳腺癌组织中肿瘤抑制基因ｐ５３蛋白的表达和雌激素受体的状态分别进行了检测。结果３２例中ｐ５３蛋白阳性１８例,阳性率５６．３％,１８例伴有同侧腋下淋巴结转移者阳性１３例（７２．２％）３而１４例无转移者阳性５例（３５．７％）二组阳性率差异显著（ＰＭＯ．０５）。３２例中雌激素受体阳性１７例,１８例伴转移者阳性８例（４４．４％）;１４例无转移者阳性９例（６４．３％）。结果表明,ｐ５３蛋白的异常表达与乳腺癌的浸润转移有关,结合雌激素受体的检查,可作为临床预后判断一个有价值的标志。     

Q fever in the Mordvinian ASSR]

In the serological (CFT) examination of patients with elevated temperature for Q fever positive results were obtained in 8.2--14% of cases. The number of positive results of the CFT in rural districts was higher (16%) than in urban districts (10.2%). A considerable percentage of positive results was observed among the workers of a meat-packing plant (25%) and among persons who regularly received milk at their work as a special diet (25--39.2%). In the Mordovian ASSR the infection seemed to be transmitted mainly by the alimentary and contact ways.     

HPV16感染检测和TCT筛查联用的临床应用

目的评估人乳头瘤病毒(Human papillomavirus,HPV)16感染和液基薄层细胞学(thinprep cytologic test,TCT)筛查在预测宫颈病变中的临床价值。方法以门诊537例高危型HPV感染疑似宫颈病变女性为对象,进行HPV16感染分析、液基薄层细胞学和阴道镜病理检查,以病理活检为金标准,比较HPV16感染筛查方法、TCT筛查方法以及二者联用在筛查中的敏感度、特异度等指标,判断其临床应用价值。结果 HPV16感染筛查方法的敏感度为62.9%,特异度为83.5%,阳性预测值为53.4%,阴性预测值为88.2%;TCT筛查方法的敏感度为41.2%,特异度为92.7%,阳性预测值为62.9%,阴性预测值为84.0%;二者联合筛查,以HPV16感染或TCT异常为阳性,敏感度为84.7%,特异度为75.8%,阳性预测值为51.2%,阴性预测值为94.3%。结论 HPV16感染联合TCT异常筛查可以提高筛查的灵敏度,特异度也在可接受范围内,可以作为宫颈防癌初筛方法。     

Achievements and Challenges upon the Implementation of a Program for National Control of Congenital Chagas in Bolivia: Results 2004–2009

Bolivia is one of the most endemic countries for Chagas disease. Data of 2005 shows that incidence is around 1.09‰ inhabitants and seroprevalence in children under 15 ranged from 10% in urban areas to 40% in rural areas. In this article, we report results obtained during the implementation of the congenital Chagas program, one of the biggest casuistry in congenital Chagas disease, led by National Program of Chagas and Belgian cooperation from 2004 to 2009. The program strategy was based on serological results during pregnancy and on the follow up of children born from positive mothers until one year old; if positive, treatment was done with Benznidazole, 10 mg/Kg/day/30 days with one post treatment control 6 months later. Throughout the length of the program, a total of 318,479 pregnant women were screened and 23.31% were detected positive. 42,538 children born from positive mothers were analyzed at birth by micromethod, of which 1.43% read positive. 10,120 children returned for their second micromethod control of which 2.29% read positive, 7,650 children returned for the serological control, of which 3.32% turned out positive. From the 1,093 positive children, 70% completed the 30 day-treatment and 122 returned for post treatment control with 96% showing a negative result. It has been seen that maternal-fetal transmission rates vary between 2% and 4%, with an average of 2.6% (about half of previously reported studies that reached 5%). In this work, we show that it is possible to implement, with limited resources, a National Congenital Chagas Program and to integrate it into the Bolivian health system. Keys of success are population awareness, health personnel motivation, and political commitment at all levels.     

吸毒人群中HIV/HCV核酸和抗体关系的分析

研究了高危人群中HIV/HCV核酸和抗体的关系。从新疆地区采集吸毒人群的血样,并对其进行HIV/ HCV核酸和抗体的检测。320例吸毒人员血浆样品中HCV抗体阳性为80．3％,HIV抗体阳性率为41．9％,HIV 和HCV共感染者为38．3％。HIV RNA与抗体的总符合率为98．8%,在186例HIV抗体阴性样品中可能有2例 为HIV感染的窗口期。HCV抗体和HCV RNA的阳性符合率为92．6％,HCV RNA与HCV抗体的总符合率为 90．0％,以上结果说明在HIV／HCV的高流行区进行HIV／HCV核酸检测可以发现病毒感染的窗口期,而约8% 的HCV抗体阳性样品为病毒核酸阴性,也值得进一步研究。     

A rapid immunochromatographic assay for the detection of Mycobacterium tuberculosis antigens in pulmonary samples from HIV seropositive patients and its comparison with conventional methods

As tuberculosis generates a highly heterogeneous antibody repertoire, its diagnosis requires tests based on cocktails of antigens. We describe a new, rapid method called rapid immunochromatographic assay (RICA) for cocktail-based diagnosis, which can detect Mycobacterial antigens in sputum specimens. Six antigenic fractions of pathogenic Mycobacterium tuberculosis were used in combination as the capture antigens in the control line of the flow-through assay. Antigen detection of 200 sputum samples from HIV seropositive patients by RICA assay gave a sensitivity of 97.9%, specificity of 99.0%, positive predictive value of 98.9%, negative predictive value of 98.0%, false positive rate of 0.9%, false negative rate of 2.0%, prevalence rate of 49%, likelihood ratio for positive results 97 and likelihood ratio for negative results 0.02. The combination of RICA and AFB staining gave a sensitivity of 100%, specificity of 100%, positive predictive value of 100%, negative predictive value of 100%, false positive rate of 0%, false negative rate of 0%, likelihood ratio for negative results 0. The assay was simple, rapid and economical for the detection of M. tuberculosis infection and suitable for large scale screening of samples in endemic areas without any sophisticated equipment. The results of the assay proved to be superior to conventional methods and combined with clinical data, could form the basis for starting an earlier course of treatment.     

A new capture test using conjugated peptides for the detection of HIV antibodies

Abstract A new capture test utilizing conjugated peptides has been developed for the detection of antibodies elicited against HIV-1. Human sera diluted 1:1000 were incubated in ELISA plates precoated with protein G. The captured IgG were allowed to react with three synthetic peptides corresponding to the gp41 sequence (591–611) YLKDQQLLGIWGCSGKLICTT, the gp120 sequence (314–329) IRIQRGPGRAFVTIGK and the p27 sequence (182–198) EWRFDSRLAFHHVAREL. The peptides were used in the form of N -hydroxysuccinimido-biotin ovalbumin conjugates. Peroxidase-labelled streptavidin was used to detect antigen-antibody complexes. The sensitivity and specificity of detection of antibodies were analyzed with 40 HIV positive sera, 10 seroconverting sera and 21 normal human sera (NHS). The results were compared with a commercial indirect ELISA in which a single conjugated gp41 peptide was used as antigenic probe. This indirect ELISA recognized 100% of the HIV positive and the seroconverting sera. The new capture test using the gp41 conjugated peptide also recognized 100% of the HIV positive sera but was more specific since it gave no false positive results whereas the indirect test did. The gp120 and p27 conjugated peptides detected 35/40 (87.5%) and 31/40 (77.5%) of HIV positive sera respectively and also detected 9/10 (90%) and 10/10 (100%) of the seroconverting sera respectively, without any false positive results (0/21). The proposed new capture test is a very sensitive and specific assay for detecting HIV antibodies.     

Significance of Isolated Positive IgM Serologic Results by Enzyme Immunoassay for Coccidioidomycosis

Serologic testing is important for diagnosis of coccidioidomycosis. Many methods are available for diagnostic testing. Enzyme immunoassay (EIA) can be performed quickly and locally but has the potential for false-positive results in patients manifesting a positive EIA for immunoglobulin M (IgM) antibodies and a negative EIA for immunoglobulin G (IgG). We retrospectively reviewed the charts of 405 patients with coccidioidal serologic testing performed between 1999 and 2003. Of 706 EIAs, 37 (5%) produced test results for 28 patients that showed isolated IgM positivity. Among these 28 patients, 24 (86%) had positive serologic findings by other methods (complement fixation or immunodiffusion or both), and 7 (25%) had positive microbiologic or histopathologic findings. All 4 (14%) patients without other positive serologic results had diagnostic tests with positive microbiologic or histopathologic results. No false-positive IgM assays were observed. We conclude that the false-positive rate of the EIA IgM is low, and that an isolated positive EIA IgM should prompt further follow-up and diagnostic testing. J. T. Currier was a Visiting Research Trainee at the Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ.     

A new capture test using conjugated peptides for the detection of HIV antibodies.

A new capture test utilizing conjugated peptides has been developed for the detection of antibodies elicited against HIV-1. Human sera diluted 1:1000 were incubated in ELISA plates precoated with protein G. The captured IgG were allowed to react with three synthetic peptides corresponding to the gp41 sequence (591-611) YLKDQQLLGIWGCSGKLICTT, the gp120 sequence (314-329) IRIQRGPGRAFVTIGK and the p27 sequence (182-198) EWRFDSRLAFHHVAREL. The peptides were used in the form of N-hydroxysuccinimido-biotin ovalbumin conjugates. Peroxidase-labelled streptavidin was used to detect antigen-antibody complexes. The sensitivity and specificity of detection of antibodies were analyzed with 40 HIV positive sera, 10 seroconverting sera and 21 normal human sera (NHS). The results were compared with a commercial indirect ELISA in which a single conjugated gp41 peptide was used as antigenic probe. This indirect ELISA recognized 100% of the HIV positive and the seroconverting sera. The new capture test using the gp41 conjugated peptide also recognized 100% of the HIV positive sera but was more specific since it gave no false positive results whereas the indirect test did. The gp120 and p27 conjugated peptides detected 35/40 (87.5%) and 31/40 (77.5%) of HIV positive sera respectively and also detected 9/10 (90%) and 10/10 (100%) of the seroconverting sera respectively, without any false positive results (0/21). The proposed new capture test is a very sensitive and specific assay for detecting HIV antibodies.     

Chlamydia trachomatis infection in rural Nova Scotia.

OBJECTIVE: To examine the demographic characteristics of patients who underwent testing for Chlamydia trachomatis and to determine the clinical and behavioural characteristics and the types of treatment for those who had positive test results. DESIGN: Case series. SETTING: Rural county in Nova Scotia. PATIENTS: All residents of the county for whom testing for C. trachomatis was ordered at the regional hospital from Sept. 1, 1990, to Mar. 31, 1991. MAIN OUTCOME MEASURES: Rates of testing and of positive test results by age and sex. Comparison of patient and physician characteristics in relation to testing rates. RESULTS: Of the 1116 patients tested 58 (5.2%) had positive test results. Females accounted for 82.8% of those with positive results whose sex could be determined. Among the females the mean age of those with a positive result was 22.3 years, as compared with 27.5 years for those with a negative result (p < 0.0001). Females 15 to 19 years of age were less likely to have a test performed than women 20 to 29 years and were more likely to have a positive test result than the women in the older groups. Almost 9% of the testing among the females was in those over 39 years of age, although no infection was seen in this age group. The number of tests ordered per general or family practitioner varied from 1 to 154; the physicians'' sex, practice location and length of time in practice did not predict the rates of positive test results. Treatment was most often in keeping with that recommended by national guidelines. Four (8.5%) of the 47 patients with positive results who were interviewed were not aware of their diagnosis, either because they had not returned for follow-up or had not being notified by the physician''s office. CONCLUSIONS: The frequency of testing for C. trachomatis infection may be less than is desirable among young patients, who, if tested, are more likely than older patients to have positive results. More understanding of the diagnostic approach taken by physicians is needed.     

Grading of the prostate carcinoma: cyto-histological correlations on 100 cases

From January 1980 to December 1983, 154 patients underwent prostatic FNAB and histological control. The sensitivity of cytology was 85%, the specificity 68% and the predictive value of positive cases 83%. The cyto-histological correlation of the grading of the 100 prostatic carcinomas histologically confirmed (85 cytologically positive for carcinoma and 15 negative or uncertain) showed a predictive value of positive results of 58%, ranging from 42% for G3, 50% for G1 and 69% for G2. The usefulness of cytological grading is stressed to monitor the follow-up of those patients treated for prostatic carcinoma who, because of the advanced stage or age, were not surgically treated.     

A quantitative enzyme-linked immunosorbent assay for bovine herpesvirus type 1 (BHV-1) antibody

A quantitative enzyme-linked immunosorbent assay (ELISA) was developed to detect and measure antibody to bovine herpesvirus type 1 (BHV-1) in cattle sera. The optical density produced from a single dilution of test serum was compared with a standard curve and the results were read and printed out from a computer interfaced to a multichannel ELISA reader. The printed results were expressed in ELISA units. The ELISA results obtained on 370 cattle sera were compared with those of the serum neutralisation test (SNT). An agreement of 90.5% was obtained when reciprocal SNT titres equal to or greater than 4 and IgG ELISA units equal to or greater than 50 were taken as indicative of a specific reaction. Of the 370 sera, 35 gave discrepant results of which 21 were SNT positive/IgG ELISA negative and 14 were SNT negative/IgG ELISA positive. When the SNT positive sera negative in the IgG ELISA were tested in an IgM ELISA, 19 were found to be positive. Thus, when the IgG and IgM ELISA results were combined the overall agreement between the ELISA and SNT increased to 95.7%. The IgG ELISA had a sensitivity of 82.4% and specificity of 94.4% relative to the SNT, whereas the combined IgG and IgM ELISA results gave a sensitivity and specificity of 98.3% and 94.4% respectively. There was a good positive correlation between the two tests (r = 0.86).     

猪传染性胸膜肺炎病料中PCV_2和PRRSV的PCR检测

应用PCR方法对从山东省不同地区采集的2 5 3份猪传染性胸膜肺炎肺脏和12 5份临床健康猪肺脏进行PCV_2和PRRSV的检测。结果显示,在传染性胸膜肺炎猪肺脏中,171份为PCV_2阳性,阳性率达6 7 5 % ;10 1份样品为PRRSV阳性,阳性率达4 0 % ;其中,6 8份样品同时检出PCV_2和PRRSV ,共感染阳性率达2 6 8%。而临床健康猪肺组织中,2 1份样品PCV_2检测结果为阳性,阳性率为16 8% ;12份样品PRRSV检测结果阳性,阳性率为9 6 % ,PCV_2和PRRSV共感染未检出。统计结果显示,传染性胸膜肺炎发病猪与临床健康猪PCV_2、PRRSV及PCV_2和PRRSV共感染的阳性率差异极显著,传染性胸膜肺炎发病猪的肺脏中PCV_2和PRRSV的检出率明显高于临床健康猪。上述检测结果提示,猪传染性胸膜肺炎的发生可能与PCV_2和PRRSV的感染和共感染有关     

住院腹泻患者艰难梭菌快速检测结果分析

目的 了解住院腹泻患者艰难梭菌带菌情况,为抗生素相关腹泻患者的诊断和治疗提供参考。方法 收集2015年9月至2016年8月住院腹泻患者粪便标本163份,用艰难梭菌快速检测试剂盒检测艰难梭菌。结果 艰难梭菌检出总阳性率为20.86%（34/163）,其中春季16.67%、夏季15.79%、秋季17.86%、冬季27.87%,经比较差异无统计学意义（2=2.943,P＞0.05）;成人粪便标本阳性率为22.52%（25/111）,儿童粪便标本阳性率为17.31%（9/52）,差异无统计学意义（2=0.583,P＞0.05）;男性粪便标本阳性率为21.69%（18/83）,女性粪便标本阳性率为20.0%（16/80）,差异无统计学意义（2=0.202,P＞0.05）;艰难梭菌阳性患者抗菌药物平均使用天数为12.74 d,阴性患者为8.21 d,差异有统计学意义（t=－7.81,P＜0.01）。结论 住院腹泻患者艰难梭菌阳性率高低与抗菌药物使用时间长短有关。