造血干细胞移植后患者侵袭性真菌感染的抗原检测  

Study on antigen detection of invasive fungal infection in hematopoietic stem cell transplantation patients

作　　者：左向华[1] 陈建魁[1] 尹秀云[1] 于农[1] 金欣[1] 宋世平[1] 王淼[1] 曾利军[1] 

机构地区：[1]军事医学科学院附属医院检验科,北京100071

出　　处：《中国卫生检验杂志》2010年第12期3378-3379,3381,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨抗原检测在造血干细胞移植后侵袭性真菌感染(IFI)早期诊断中的价值。方法:对97例具有真菌感染高危因素的移植后患者,分别检测半乳甘露聚糖抗原(GM)和(1,3)-β-D-葡聚糖(BG)。结果:BG检测对侵袭性念珠菌和曲霉菌感染的敏感度分别为82.8%和84.6%,特异度分别为51.8%和50.9%。GM对侵袭性曲霉菌的敏感度和特异度为80.8%和93.0%,联合检测对侵袭性曲霉菌的敏感度和特异度为80.8%和100.0%。结论:BG抗原检测对曲霉和念珠菌感染诊断都有较好的敏感性,但是特异度较低,GM对曲霉菌感染有较好的敏感性和特异性,对非曲霉菌的其他真菌感染没有诊断意义,BG联合GM检测能提高曲霉菌感染诊断的特异性,降低假阳性的发生率,具有较好的临床应用前景。Objective：To evaluate the role of fungal antigen detection in the early diagnosis of invasive fungal infection after hematopoietic stem cell transplantation.Methods： Blood samples were obtained from 97 patients with hematopoietic stem cell transplantation.BG and GM were detected by Microbiology Kinetic Rapid Reader MB-80 and enzyme linked immunosorbent assay.Results： In the studies of hematopoietic stem cell transplantation patients on early diagnostic,the BG test for patients infected with invasive aspergillosis（IA） and invasive candidiasis（IC） shown the sensitivity were 82.8% and 84.6%,the specificity were 51.8% and 50.9%.The sensitivity and specificity of the GM test were 80.8% and 93.0% for IA patients.the BG combined with GM test shown sensitivity,specificity,were 80.8%,100%.Conclusion： The BG have shown high sensitivity and low specificity for patients infected with IA and IC.The performance of GM assay for IA patients have show high sensitivity and specificity.BG combined with GM test for IA patients have shown a very high specificity and decreased false positive cases,it could be a more reliable method for early diagnosis of IA.

关 键 词：半乳甘露聚糖抗原 (1 3)-β-D-葡聚糖 侵袭性真菌感染 造血干细胞移植 

分 类 号：R379[医药卫生—病原生物学]