血清(1,3)-β-D葡聚糖与尿真菌培养联合检测对泌尿系侵袭性真菌感染的诊断价值  

Diagnostic value of combined detection of serum (1,3)-β-D-glucan and urine fungal culture for invasive fungal infection in urinary system

作　　者：李秀文[1] 王运铎[1] 张毅华[1] 

机构地区：[1]大连市中心医院检验科,辽宁大连116033

出　　处：《中国微生态学杂志》2017年第12期1437-1439,1451,共4页Chinese Journal of Microecology

摘　　要：目的探讨血清(1,3)-β-D葡聚糖与尿真菌培养联合检测对泌尿系侵袭性真菌感染(IFI)的诊断价值。方法选取疑似泌尿系IFI患者157例,根据临床诊断,分为IFI组(48例)和非IFI组(109例),进行血清(1,3)-β-D葡聚糖检测(G试验)和尿真菌培养,比较两种方法单独和联合检测对泌尿系IFI诊断的灵敏度、特异度、阳性预测值、阴性预测值和Youden指数。结果 G试验和尿真菌培养的灵敏度、特异度、阳性预测值、阴性预测值和Youden指数依次为(87.5%、89.6%)、(77.1%、78.9%)、(62.7%、65.2%)、(93.3%、94.5%)和(0.646、0.685);联合检测的灵敏度、特异度、阳性预测值、阴性预测值和Youden指数依次为79.2%、98.2%、95.0%、91.5%和0.774。三者均具有较高阴性预测值,而联合检测的特异度、阳性预测值和Youden指数明显高于单独检测,差异有统计学意义(Ps<0.05)。结论 G试验与尿真菌培养联合检测诊断泌尿系IFI具有较高的阴性预测值和阳性预测值,减少了假阳性结果,较单独检测具有更大的诊断价值。Objective To explore the diagnostic value of combined detection of serum（1,3）-β-D-glucan and urine fungal culture for invasive fungal infection（IFI）in urinary system.Methods One hundred and fiftyseven patients with suspected urinary IFI were selected and divided into IFI group（48 cases）or non-IFI group（109 cases）according to clinical diagnosis.Serum（1,3）-β-D-glucan detection（G test）and urine fungal cultivation were conducted.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the two methods alone respectively and in combination were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of G test vs urine fungal cultivation were（87.5% vs 89.6%）,（77.1% vs 78.9%）,（62.7% vs 65.2%）,（93.3% vs 94.5%）and（0.646 vs 0.685）respectively,while those of combined detection were 79.2%,98.2%,95.0%,91.5% and 0.774 respectively.All the three groups had high negative predictive value,while the specificity,positive predictive value and Youden index of combined detection were significantly higher than those of the two test alone（Ps0.05）.Conclusion Combined detection of G test and urine fungal culture has a high negative predictive value and positive predictive value in the diagnosis of urinary IFI.It reduces false positive results,and has a better diagnostic value than each of the two detections.

关 键 词：(1 3)-β-D葡聚糖 G试验 真菌 侵袭性真菌感染 

分 类 号：R446[医药卫生—诊断学]