血浆1-3-β-D葡聚糖对真菌性鼻窦炎的诊断价值  

Diagnostic value of plasma 1-3-β-D glucan for fungal rhinosinusitis

作　　者：余鹏举[1] 许风雷[2] 杨军[1] 陈伟[3] 江满杰[3] 

机构地区：[1]江苏省昆山市中医医院耳鼻咽喉科,江苏昆山215300 [2]山东大学第二医院耳鼻咽喉头颈外科,山东济南250000 [3]南京军区南京总医院耳鼻咽喉-头颈外科,江苏南京210002

出　　处：《山东大学耳鼻喉眼学报》2016年第4期94-97,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的明确血浆1-3-β-D葡聚糖对真菌性鼻窦炎的诊断价值。方法选择2014年1月至2015年12月接受鼻窦炎手术的患者,依据术后病理诊断分为观察组(真菌性鼻窦炎)及对照组(细菌性鼻窦炎)。比较手术前后外周血1-3-β-D葡聚糖、C-反应蛋白(CRP)及降钙素原(PCT)的改变。结果共纳入符合研究条件的患者83例,其中观察组41例,对照组42例。观察组术前血浆1-3-β-D葡聚糖水平显著高于对照组(P<0.05),术后1-3-β-D葡聚糖水平显著降低(P<0.05)。相关性分析显示,观察组术前血浆1-3-β-D葡聚糖水平与PCT(t=0.701,P=0.002)及CRP(t=0.846,P=0.002)均呈现显著正相关。ROC曲线分析显示,当1-3-β-D葡聚糖取值为12.0 pg/m L时对感染的诊断敏感性为90.48%,特异性为95.12%,优于PCT及CPR。结论 1-3-β-D葡聚糖对真菌性鼻窦炎的诊断较为可靠,有望成为辅助术前诊断的实用指标。Objective To analyze the value of plasma 1-3-β-D glucan for diagnosis of fungal rhinosinusitis. Methods Patients with nasosinusitis underw ent surgery treatment at our hospital from 2014 to 2015 were selected and divided into observation group（ fungal rhinosinusitis） and control group（ bacterial rhinosinusitis） according to the postoperative pathological diagnosis. Changes of 1-3-β-D glucan,C-reactive protein（ CRP） and procalcitonin（ PCT） in peripheral blood were compared. Results A total of 83 patients were enrolled,in which 41 cases were divided in observation group and 42 cases were divided in control group. Patients in observation group had a higher level of 1-3-β-D glucan than that of control group before surgery（ P〈0. 05）,but decreased significantly after surgery（ P〈0. 05）. Correlation analysis showed that,for patients in observation group,the levels of 1-3-β-D glucan had significant positive correlation with CRP（ t = 0. 846,P = 0. 002） and PCT（ t = 0. 701,P = 0. 002）. ROC analysis showed that the 1-3-β-D glucan cut-off point value of 12. 0 pg / m L,as used for the diagnosis of fungal rhinosinusitis,provided a sensitivity of 90. 48%,a specificity of 95. 12%,better than these of CRP and PCT. Conclusion Plasma 1-3-β-D glucan assay for diagnosis of fungal rhinosinusitis is reliable and it has potential to become a practical indicator for auxiliary preoperative diagnosis.

关 键 词：1-3-β-D葡聚糖 真菌性鼻窦炎 诊断 C-反应蛋白 降钙素原 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]