(1,3)-β-D-葡聚糖对普外科患者深部真菌感染的诊断分析  

Value of (1,3)-β-D-glucan in diagnosis of deep fungal infections in patients of department of general surgery

作　　者：王毅 朱冠保 饶尚锐 王中林 何杰 黄节 

机构地区：[1]温州市中心医院普外科,浙江温州325000

出　　处：《中华医院感染学杂志》2015年第14期3130-3132,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1200081374)

摘　　要：目的评估血浆(1,3)-β-D-葡聚糖对普外科患者深部真菌感染的诊断价值,为普外科患者深部感染的早发现、早诊断、早治疗提供科学依据。方法选取2010年2月-2015年2月普外科疑似深部真菌感染患者184例及40名健康人员为研究对象,采用真菌感染快速检测试剂盒检测并比较两组血浆(1,3)-β-D-葡聚糖水平,与传统真菌培养结果比较;采用ROC曲线分析两种诊断方法的临床价值。结果 (1,3)-β-D-葡聚糖法检测深部真菌感染患者阳性43例,阳性率为23.37%,传统真菌培养法检测阳性32例,阳性率为17.40%,(P=0.035),两种方法的检测结果具有高度的一致性,Kappa系数K=0.617(P<0.001);(1,3)-β-D-葡聚糖诊断深部真菌感染的灵敏度为81.25%、特异度为88.82%;当以(1,3)-β-D-葡聚糖=16.59pd/ml为临界值时,诊断深部真菌感染的灵敏度与特异度均达到最大,灵敏度为92.03%、特异度为83.17%。结论 (1,3)-β-D-葡聚糖可作为普外科深部真菌感染特异性生物标志物,具有较高的早期诊断效率,可为其诊治赢得宝贵时间。OBJECTIVE To evaluate the value of plasma（1,3）-β-D-glucan in diagnosis of deep fungal infections in patients of department of general surgery so as to provide scientific bases for early discovery,diagnosis,and treatment of the deep fungal infections.METHODS From Feb 2010 to Feb 2015,totally 184 patients with suspected deep fungal infections of the general surgery department and 40 healthy people were recruited as the study objects,then the level of plasma（1,3）-β-D-glucan was determined by using rapid detection kit for fungal infections and was compared between the two groups,the result was compared with the result of the conventional fungal culture,and the clinical values of the two diagnosis methods were observed with the use of ROC curve.RESULTS The result of the（1,3）-β-D-glucan test showed that 43 cases were positive for deep fungal infections,with the positive rate of 23.37%;the result of the conventional fungal culture indicated that 32 cases were tested positive,with the positive rate of 17.40%,（P=0.035）;the results of the two diagnosis methods showed the high degree of consistency,with the Kappa coefficient of 0.617（P〈0.001）.The sensitivity of the（1,3）-β-D-glucan was 81.25%in the diagnosis of deep fungal infections,the specificity 88.82%.As 16.59pd/ml was set as the critical value of the（1,3）-β-D-glucan,both the sensitivity and specificity maximized in the diagnosis of deep fungal infections,with the sensitivity 92.03%,the specificity 83.17%.CONCLUSIONThe（1,3）-β-D-glucan can be used as the specific biomarker for the diagnosis of deep fungal infections in the patients of department of general surgery,and it is highly efficient in the early diagnosis and may win precious time for the treatment.

关 键 词：(1 3)-β-D-葡聚糖 深部真菌感染 诊断价值 

分 类 号：R446[医药卫生—诊断学]