检测血浆(1→3)-β-D葡聚糖对免疫抑制大鼠侵袭性肺曲霉病的诊断价值  

Diagnostic value of detecting (1→3)-β-D-glucan for invasive pulmonary aspergillosis in rats

作　　者：高蕾[1] 周新[1] 丁星[1] 王笑秋[1] 周妍[1] 荣令[1] 

机构地区：[1]上海交通大学附属第一人民医院呼吸科,200080

出　　处：《上海医学》2009年第10期881-884,I0001,共5页Shanghai Medical Journal

基　　金：上海市卫生局科技发展基金资助项目(044019)

摘　　要：目的评价(1→3)-β-D葡聚糖(BG)对免疫抑制大鼠侵袭性肺曲霉病(IPA)的诊断价值。方法建立免疫抑制大鼠肺部曲霉感染模型,应用MB-80微生物快速动态检测系统及GKT-5 MSet动态真菌检测试剂盒(G试验)定量检测BG抗原,并将其与酶联免疫吸附试验(ELISA)检测血清半乳甘露聚糖抗原(GM试验)进行比较。结果①免疫抑制感染组9份血样出现阳性结果,阳性率为60%(9/15),大鼠的血浆BG水平为10.12～181.50 ng/L,中位值为56.27 ng/L;免疫抑制感染组G试验阳性率显著高于正常对照组(0,P<0.01)。②G试验诊断IPA的敏感度为60%,特异度为97%;GM试验的敏感度和特异度分别为73%和91%。③G试验与GM试验联合应用诊断IPA的敏感度和特异度均有所提高,分别为86%和98%。结论G试验作为一种新的诊断IPA的无创检测指标,有较高的特异度,具有较好的临床诊断价值,与GM试验联合应用可进一步提高诊断IPA的敏感度和特异度。Objective To evaluate the diagnostic value of detecting plasma （1→3）-β-D-glucan （BG） for invasive pulmonary aspergillosis in rats. Methods Pulmonary aspergillosis model was established with immunosuppressive rats. MB-80 Microbiology Kinetic Rapid Reader and GKT-5M Set（G test） were used to detect the plasma contents of BG, and the results were compared with those detected by ELISA （GM test, Platelia Aspergillus）. Results ① Nine samples （60.0%） in the immunosuppression infection group had positive results, with the plasma BF level being 10.12--181.50 ng/L [a median of 56.27 ng/L];the rest 6 samples had a negative results. The positive rate of G test in the immnuosuppression infection group was significantly higher than that of the normal control group （0, P〈0.01）. ② The sensitivity and specificity of G test for IPA were 60% and 97%, respectively; those of GM test were 73 % and 91%, respectively. ③The combination of G test and GM test had a higher sensitivity and specificity in diagnosis of IPA, being 86% and 98%, respectively. Conclusion G test, as a novel non-invasive index for diagnosis of IPA, has high specificity and satisfactory clinical diagnosis value. When combined with GM test, the sensitivity and specificity of G test for diagnosis of IPA are greatly increased. （Shanghai Med J, 2009, 32; 881-884）

关 键 词：侵袭性肺曲霉病 葡聚糖 免疫抑制 诊断 

分 类 号：R519[医药卫生—内科学]