儿童血液真菌抗原检测的应用研究(英文)  

Prospective fungal antigen testing in high-risk pediatric patients

作　　者：赵醴[1] 王莹[1] 周云芳[2] 李璧如[1] 陈静[3] 薛惠良[3] 汤静燕[3] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心儿童重症监护科 [2]上海交通大学医学院附属上海儿童医学中心感染科 [3]上海交通大学医学院附属上海儿童医学中心血液肿瘤科

出　　处：《临床儿科杂志》2010年第1期1-6,共6页Journal of Clinical Pediatrics

摘　　要：目的评价血液半乳甘露聚糖(galactomannan,GM)和(1,3)-β-D葡聚糖[(1,3)-β-D-glucan,BG]试验及两者联合应用在儿科侵袭性真菌感染(IFI)高危人群中的诊断价值。方法GM采用双抗体夹心酶联免疫吸附法(PlateliaTM Aspergillus试剂盒)检测,BG采用动态浊度法(GKT-5M Set动态真菌检测试剂盒)。GM阳性定义为连续2次不同时点I≥0.5或单次I≥0.8;BG阳性为≥10pg/ml。结果130例入选研究,其中确诊IFI2例,临床诊断20例。BG和GM试验敏感度、特异度分别为81.8%,82.4%和75.0%,94.4%。两者联合应用诊断侵袭性曲霉菌病(IA)敏感度为50.0%,特异度为96.3%。结论BG和GM对儿童IFI检测有较好的敏感性和特异性,有助于高危患者的筛查。两者联合应用可提高IA诊断的特异性。Objective To assess the diagnostic potential of circulating galactomannan （ GM） ,（ 1,3）-β-Dglucan （ BG） ,and a combination of both biomarkers among high-risk pediatric patients. Methods Circulating GM antigen was detected by ELISA kits （PlateliaTM Aspergillus） and BG antigen by a turbidimetric kinetic method （GKT5M Set Kinetic Fungus Detection Kit）. Positive tests were defined by two consecutive values of GM index ≥ 0.5 or by a single value ≥ 0.8,and by BG detection ≥ 10 pg / ml. Results A total of 130 patients were enrolled. Two was identified with proven IFI,twenty probable IFI. Sensitivity,specificity were 81.8%,82.4% for plasma BG detection,respectively; 75.0% ,94.4% for GM detection,respectively; 50.0% ,96.3% for combined GM and BG detection,respectively. Conclusions Both circulating GM and BG detections are available for most of the common pathogens and demonstrated desirable sensitivity and specificity among pediatric high-risk population. Both assays can be used as prospective screening tools. Combination of detections of both biomarkers would improve specificity for IA diagnosis.

关 键 词：侵袭性真菌感染 (1 3)-β-D-葡聚糖 半乳甘露聚糖 儿童 

分 类 号：R725.1[医药卫生—儿科] R446.6[医药卫生—临床医学]