高分辨CT联合GM试验在免疫功能低下患者肺曲霉菌感染早期诊断的价值  

The Early Diagnostic Value of HRCT Combined with GM Test for Pulmonary Aspergillosis Infections in Immunocompromised Patients

作　　者：陈立鹏[1] 刘灶松[1] 陈亮[1] 魏新华[1] 刘伟锋[1] CHEN Li-peng;LIU Zao-song;LIU Wei-feng(Department of Radiology,Guangzhou First People's Hospital,Guangzhou 510180,Guangdong Province,China)

机构地区：[1]广州市第一人民医院放射科,广东广州510180

出　　处：《中国CT和MRI杂志》2018年第2期57-60,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨高分辨CT联合半乳甘露聚糖含量检测(GM试验)在免疫功能低下患者肺曲霉菌感染早期诊断的价值。方法收集高度怀疑继发侵袭性肺曲霉病的免疫功能低下患者96例,确诊后分为感染组39例和非感染组57例,采用HRCT扫描肺部,分析CT征象,同时GM试验检测患者血清半乳甘露聚糖含量,分为阳性病例及阴性病例,统计肺部HRCT和血清GM试验单独和联合应用诊断侵袭性肺曲霉病的敏感性、特异性、阳性预测值和阴性预测值。结果HRCT诊断侵袭性肺曲霉病的敏感性、特异性、阳性预测值和阴性预测值分别是66.7%、87.7%、78.8%、73.5%;血清GM试验分别是82.1%、91.2%、86.3%、88.1%;HRCT和血清GM试验并联分别是94.5%、82.5%、78.7%、96.0%;HRCT和血清GM试验串联分别是61.5%、94.7%、88.9%、78.3%。结论相对于HRCT和血清GM试验单独使用,HRCT和血清GM试验并联诊断免疫功能低下患者继发IPA的灵敏性和阴性预测值更高,串联分析时特异性、阳性预测值更高,联合应用有利于提高诊断效能。Objective To investigate the early diagnostic value of HRCT combined with GM test for pulmonary aspergillosis infections in immunocompromised patients.Methods 96 immunocompromised patients who suspected to suffer invasive pulmonary aspergillosis had been collected,and divided into two groups after diagnosed,including infection group(39 cases)and non-infection group(39 cases).HRCT scan was used to analyze the signs of pulmonary CT.At the same time,GM test was used to detect the content of galactomannan in patients,which were divided into positive and negative cases.Statistics of lung HRCT and serum GM test alone and combined diagnostic sensitivity,specificity,positive predictive value of invasive pulmonary aspergillosis and negative predictive value.Results Sensitivity,specificity,positive predictive value and negative predictive value of invasive pulmonary aspergillosis diagnosed by HRCT are 66.7%,87.7%,78.8%,73.5%.Serum GM test,respectively,82.1%,91.2%,86.3%,88.1%;The HRCT and serum GM tests parallel connection,respectively,94.5%,82.5%,78.7%,96.0%.HRCT and serum GM test series connection,respectively,61.5%,94.7%,88.9%,78.3%.Conclusion Relative to HRCT and serum GM tests used alone to diagnosis of secondary IPA of immunocompromised patients,Sensitivity and negative predictive value of HRCT and serum GM test parallel analysis are higher,and the specificity and positive predictive value of tandem analysis were higher,so the combined use of HRCT and GM tests was beneficial to improve the diagnostic efficacy.

关 键 词：HRCT GM试验 免疫功能低下 侵袭性肺曲霉病 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]