血浆（1,3）-β-D-葡聚糖检测对深部真菌感染的临床价值  

Clinical Significance of the Plasma（1, 3）-β-D-glucan Assay for Diangnosis of Invasive Fungal Infections

作　　者：杨葵[1] 丁银环[1] 田刚[1] 向成玉[1] 林雁[1] 

机构地区：[1]泸州医学院附属医院检验科,四川泸州646000

出　　处：《现代检验医学杂志》2014年第2期81-83,共3页Journal of Modern Laboratory Medicine

摘　　要：目的 血浆（1,3）-β-D葡聚糖的检测为临床提供深部真菌感染的诊断价值.方法 使用MB-80真菌快速检测仪,检测2011年1-12月泸州医学院附属医院486例不同年龄阶段疑似深部真菌感染患者的552份血浆标本中（1,3）-β-D葡聚糖的含量,将其进行卡方检验和ROC曲线分析及探讨.结果 552份标本中（1,3）-β-D葡聚糖对深部真菌感染检测的阳性率为15.94％（88/552）,培养与镜检对深部真菌感染的阳性率为12.14％（67/552）,两组差异有统计学意义（χ^2=26.80,P＜0.05）;深部真菌感染组患者血浆（1,3）-β-D葡聚糖水平为（153.18±183.04） pg/ml,无深部真菌感染组为（19.53±97.92）pg/ml,差异有统计学意义（P＜0.001）;用于诊断深部真菌感染的ROC曲线下面积为0.96（P＜0.05）;以20 pg/ml水平为临界值的血浆（1,3）-β-D葡聚糖对深部真菌感染诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为89.55％,95.46％,73.17％,98.51％和94.75％.结论 血浆（1,3）-β-D葡聚糖检测与传统方法诊断的一致性好（Kappa=0.93,P＜0.05）.该方法简便、快速且阳性率较高,可用于深部真菌感染的早期快速诊断.Objective To study the clinical significance of the plasma （1,3）-β-D-glucan assay for diagnosis of invasive fungalinfection. Methods 552 plasma （1,3）-β-D-gluean from 486 different ages of patients with suspected invasive fungal infectionwere measured by microbiology kinetic rapid reader MB-80 and the data were analyzed by chi square test and ROC curves.Results The positive rates for plasma （1,3）-β-D-glucan assay, cultivation and test under microscope were 15.94 % （88/552） and 12.14% （67/552） respectively. There was significant difference between the two groups （x2 =26.80,P〈0.05）.The mean level of plasma （1,3）-β-D-glucan of invasive fungal infection group and the control group were （153.18 ± 183.04）pg/ml and （19.53±97.92）pg/ml respectively. There was significant difference between the two groups （P〈0. 001 ） ,the ar-ea under the ROC curves of the invasive fungal infection group was 0.96 （P〈0.05）. The sensitivity, specificity, positivepredictive value,negative predictive value and accuracy for diagnosis of invasive fungal infection were 89.55% ,95.46%,73.17 %,98.51% and 94.75%,with 20 pg/ml as the cut-off value of （1,3）-β-D-glucan in plasma. Conclusion Serum （1,3 ）β-3-IYglucan assay was well in coincidence with traditional methods （Kappa 0.93, P〈 0.05 ）, which is a simple, fast andsensitive method for the early diagnosis of invasive fungal infections.

关 键 词：(1 3)-β-D葡聚糖 深部真菌 感染 ROC曲线 

分 类 号：R446.112[医药卫生—诊断学]