(1,3)-β-D-葡聚糖检测和半乳甘露聚糖抗原检测在侵袭性真菌病诊断中的价值探讨  

Detection of(1,3)-β-D-Glucan and Galactomannan for diagnosis of invasive fungal disease

作　　者：郑罡[1] 余进[1] 李雪迎[2] 万喆[1] 李若瑜[1] 

机构地区：[1]北京大学第一医院皮肤科真菌和真菌病研究中心,北京100034 [2]北京大学第一医院医学统计室,北京100034

出　　处：《中国真菌学杂志》2012年第3期132-135,共4页Chinese Journal of Mycology

基　　金：卫生部部属(管)医院2010-2012年度临床学科重点项目基金(2010-2012);艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2008ZX1004-002)

摘　　要：目的探讨(1,3)-β-D-葡聚糖检测和半乳甘露聚糖抗原检测在侵袭性真菌病诊断中的价值。方法回顾性研究北京大学第一医院2008年1月～2010年7月临床疑诊侵袭性真菌病的住院患者。根据诊断标准确定是否诊断侵袭性真菌病。分析非培养诊断方法血清半乳甘露聚糖(GM试验)和血浆(1,3)-β-D-葡聚糖(G试验)的敏感度和特异度,以及二者联合应用后诊断的敏感度和特异度。结果 GM试验灵敏度为70%,特异度为84%;G试验灵敏度为50%,特异度为92%。GM试验和G试验二者联合试验时,其灵敏度和特异度分别为93%和78%。结论 GM试验和G试验均对侵袭性真菌病具有诊断价值,二者联合应用使其应用价值进一步提高。Objective To evaluate the non-culture diagnostic methods for diagnosis of invasive fungal disease （IFD）.Methods A retrospective study was performed on hospitalized patients of Peking University First Hospital who were at risk of IFD. The diagnosis of invasive fungal infection was according to revised definitions. Non-culture methods including galactomannan emzyme immunoassay （GM test）and （1,3）-β-D-glucan assay （G test） were analysed of sensitivity, specificity, and concordance rate, respectively. Two tests were combined to evaluate the changes of sensitivity, specificity, and concordance rate.Results The sensitivity and specificity were 70%, 84% in GM test; 50%, 92% in G test; and 93%, 78% in combined utility of two tests.Conclusions The GM test and G test were both useful in diagnosis of IFD. The better sensitivity and concordance rate might be acquired by combining these two tests.

关 键 词：侵袭性真菌病 诊断 半乳甘露聚糖 (1 3)-β-D-葡聚糖 

分 类 号：R446.53[医药卫生—诊断学]