血浆(1,3)-β-D-葡聚糖在侵袭性真菌感染临床诊治中的应用评价  

Value of plasma (1,3)-β-D-glucan in clinical diagnosis and treatment of invasive fungal infection

作　　者：申旺 叶丽燕 杨文丽[2] 谭晓宇 黄晨娟 陈彦波 SHEN Wang;YE Li-yan;YANG Wen-li;TAN Xiao-yu;HUANG Chen-juan;CHEN Yan-bo(Wuyi Traditional Chinese Medicine Hospital Affiliated of Jinan University ,Jiangmen, Guangdong 529000, China)

机构地区：[1]暨南大学附属五邑中医院检验科,广东江门529000 [2]江门市中心医院病理科,广东江门529030

出　　处：《中华医院感染学杂志》2018年第9期1288-1291,共4页Chinese Journal of Nosocomiology

基　　金：江门市科技局课题基金资助项目(2017A4033)

摘　　要：目的探讨血浆(1,3)-β-D-葡聚糖在侵袭性真菌感染(IFI)诊断和治疗中的临床应用价值。方法选取暨南大学附属五邑中医院2015年10月-2017年3月收治的70例IFI患者,40例细菌感染患者,40名健康人群为研究对象,采用免疫比浊法检测各组的血浆(1,3)-β-D-葡聚糖水平,并对IFI患者的血液和可疑分泌物进行真菌培养;同时检测IFI患者抗真菌治疗后第7天和第14天的血浆(1,3)-β-D-葡聚糖水平。结果 IFI组血浆(1,3)-β-D-葡聚糖水平高于细菌感染组和健康对照组,细菌感染组血浆(1,3)-β-D-葡聚糖水平高于健康对照组,差异均有统计学意义(P<0.05);血浆(1,3)-β-D-葡聚糖诊断IFI的敏感度、阳性预测值、阴性预测值、准确度均优于真菌培养,差异有统计学意义(P<0.05);病情好转组第7天和第14天的血浆(1,3)-β-D-葡聚糖较治疗前有明显降低(P<0.05),病情稳定组无明显变化(P>0.05),而病情加重组第7天和第14天血浆(1,3)-β-D-葡聚糖与治疗前比较有明显上升(P<0.05)。结论血浆(1,3)-β-D-葡聚糖在侵袭性真菌感染的诊断和治疗中均有重要的临床价值。OBJECTIVE To explore the clinical value of plasma（1,3）-β-D-glucan in diagnosis and treatment of invasive fungal infection（IFI）.METHODS A total of 70 IFI patients who were treated in Wuyi Traditional Chinese Medicine Hospital Affiliated of Ji nan University from Oct 2015 to Mar 2017 were enrolled in the study,40 patients with bacterial infection and 40 healthy people were recruited as the study objects.The plasma（1,3）-β-D-glucan levels were determined by using immunoturbidimetry,the fungal culture was carried out for blood and suspicious secretions species of the IFI patients,the plasma（1,3）-β-D-glucan levels of the IFI patients were determined on Day 7 and Day 14 after antifungal therapy,and the statistical analysis was performed with the use of SPSS19.0 software.RESULTS The plasma（1,3）-β-D-glucan level of the IFI group was significantly higher than that of the bacterial infection group and the control group,the plasma（1,3）-β-D-glucan level of the bacterial infection group was significantly higher than that of the control group（P〈0.05）.The sensitivity,positive predictive value,negative predictive value and accuracy of the plasma（1,3）-β-D-glucan were significantly higher than those of the fungal culture in diagnosis of IFI（P〈0.05）.The plasma（1,3）-β-D-glucan level of the condition improved group was significantly lower on Day 7 and Day 14 than before the treatment（P〈0.05）,there was no significant change in the stable condition group（P〉0.05）,while the plasma（1,3）-β-D-glucan level of the aggravated condition group was significantly higher on Day 7 and Day 14 than before the treatment（P〈0.05）.CONCLUSIONThe plasma（1,3）-β-D-glucan shows significant value in diagnosis and treatment of IFI.

关 键 词：(1 3)-β-D-葡聚糖 侵袭性真菌感染 诊断 治疗 

分 类 号：R765[医药卫生—耳鼻咽喉科]