肾移植受者侵袭性曲霉菌感染的早期血清学诊断  

Early serological diagnosis of invasive aspergillosis in renal transplant recipients

作　　者：石向华[1] 范礼佩[1] 刘丁[1] 李留洋[1] 李民[1] 

机构地区：[1]南方医科大学珠江医院器官移植中心,广东广州510282

出　　处：《南方医科大学学报》2015年第11期1659-1661,共3页Journal of Southern Medical University

基　　金：广东省医学科学技术研究基金(WSTJJ20101201362101197808290619)

摘　　要：目的探讨1,3-β-D葡聚糖(BG)与半乳甘露聚糖(GM)在肾移植受者侵袭性曲霉菌感染(IA)早期血清学诊断中的临床价值。方法收集69例肾移植受者的血液标本,分成:确诊组、临床诊断组、拟诊组和非感染组,对4组血液样本进行检测及统计学分析。结果确诊组、临床诊断组、拟诊组的BG浓度显著高于对照组(P<0.05),其敏感性、特异性阳性预测值、阴性预测值分别为69.49%、70%、93.18%、35.71%。3组的GM浓度亦显著高于对照组(P<0.05);其敏感性、特异性阳性预测值、阴性预测值分别为84.75%、90%、96.15%、52.63%。结论血中的BG和GM浓度检测可以作为肾移植受者IA的早期诊断依据之一,浓度升高提示发生感染的可能。同时行BG实验与GM检测能提高诊断效能,减少漏诊。Objective To evaluate the clinical value of serum 1,3-beta-D-glucan（BG） and galactomannan（GM） detection for early diagnosis of invasive aspergillosis（IA） in patients after renal transplantation. Methods Blood samples collected from 69 renal transplant recipients were divided into diagnosis group, clinical diagnosis group, suspected diagnosis group, and non-infected group for detection of serum BG and GM. Results The mean serum levels of BG in the diagnosis group, clinical diagnosis group, and suspected diagnosis group were significantly higher than that in non-infected group（P〈0.05）. The sensitivity, specificity, and positive and negative predictive values of BG was 69.49%, 70%, 93.18% and 35.71% for IA diagnosis,respectively. The serum levels of GM in the 3 diagnosis groups were also significantly higher than that in the non-infected group（P〈0.05） with the sensitivity, specificity, and positive and negative predictive values of 84.75%, 90%, 96.15% and 52.63%for IA diagnosis, respectively. Conclusion Increased serum BG and GM levels can serve as the evidence for early diagnosis of IA with a high diagnostic sensitivity and specificity in renal transplant recipients..

关 键 词：肾移植 侵袭性曲霉菌感染 1 3-β-D葡聚糖 半乳甘露聚糖 

分 类 号：R699.2[医药卫生—泌尿科学] R519[医药卫生—外科学]