血浆(1,3)-β-D葡聚糖检测在侵袭性真菌感染早期诊断中的应用  

The application of measuring plasma (1,3)-β-D glucan in early diagnosis of invasive fungual infection

作　　者：秦庆[1] 胡瑛[1] 

机构地区：[1]中国人民解放军第210医院,116021

出　　处：《实用医技杂志》2013年第10期1048-1050,共3页Journal of Practical Medical Techniques

摘　　要：目的探讨血浆(1,3)-β-D葡聚糖在侵袭性真菌感染(IFI)早期诊断中的应用价值。方法应用MB-80微生物动态快速检测系统检测血浆(1,3)-β-D葡聚糖的含量。结果 IFI组与对照组血浆(1,3)-β-D葡聚糖含量比较差异有统计学意义(t=8.745,P<0.01),血浆(1,3)-β-D葡聚糖检测试验灵敏度(85.7%)明显高于真菌培养方法的灵敏度(67.9%),且血浆(1,3)-β-D葡聚糖检测试验的阳性检出率(30.9%)也高于真菌培养方法阳性检出率(24.4%)(χ2=2.24,P<0.01),同时血浆(1,3)-β-D葡聚糖检测试验阴性预测值(95.3%)高于真菌培养方法(90.3%)。结论血浆(1,3)-β-D葡聚糖含量可作为早期诊断IFI的检测方法之一,它比真菌培养方法诊断IFI性能更好。当连续监测血浆(1,3)-β-D葡聚糖水平为阴性时,感染IFI的风险较低。但此方法仍存在一定缺点,应结合其他微生物诊断方法,才能获得及时准确的诊断。Objective To explore the applied value of measuring plasma （1,3）-13-D glucan in early diagnosis of invasive fungual infection（IFI）. Methods The concentrations of（ 1,3 ）-β-D glucan in plasma samples were quantitatively detected by microbiology kinetic rapid reader MB-80. Results Mean plasma （1,3）-β-D glucan values between IFI group and healthy people group had significant differences （t=8.745, P〈0.01 ）. The test sensitivity of plasma （1, 3 ）-β-D glucan exceeded obviously that of fungal culture （85.7% and 67.9% ）, and the test positive rate of plasma （ 1,3）-β-D glucan was above that of fungal culture （30.9% and 24.4%, χ2=2.24, P〈0.01 ） and test negative predict value of plasma （1,3）-beta-D glucan was higher than that of fungal culture （95.3% and 90.3% ）. Conclusion The concentrations of （1,3）-β-D glucan in plasma is one of the methods of early diagnosis of IFI, and it＇s performance is much better than fungal culture. When plasma （ 1,3）-β-D gluean level is continuously negative, the risk of taking IFI is rather lower. This method still exists some shortcomings but combining with other microbial methods could get exact diagnosis in time.

关 键 词：血浆 葡聚糖类 早期诊断 真菌病 

分 类 号：R519[医药卫生—内科学]