支气管肺泡灌洗液1,3-β-D葡聚糖检测(G试验)、半乳甘露聚糖检测(GM试验)对早期诊断侵袭性肺部真菌感染的诊断价值  

Diagnostic value of 1, 3-isod-glucan assay in bronchoalveolar lavage solution (G test) and galactomannan assay (GM test) in early diagnosis of invasive fungal infection

作　　者：黄猛[1] 黎国喜 陈天全 HUANG Meng;LI Guo-xi;CHEN Tian-quan(Department of Respiratory Medicine,People's Hospital of Gaozhou City,Maoming,Guangdong525200,China)

机构地区：[1]高州市人民医院呼吸内科

出　　处：《临床肺科杂志》2019年第6期992-995,共4页Journal of Clinical Pulmonary Medicine

基　　金：茂名市科技立项项目(No 2018135)

摘　　要：目的研究支气管肺泡灌洗液1,3-β-D葡聚糖检测(G试验)、半乳甘露聚糖检测(GM试验)对早期诊断侵袭性真菌感染的诊断价值。方法回顾性分析2017年6月-2018年7月我院呼吸内科收治的侵袭性肺部曲霉菌感染患者50例研究对象,为研究组。另取同期我院呼吸内科收治的细菌性感染患者50例为对照组。对所有患者进行支气管肺泡灌洗液G试验与GM试验,并对试验结果进行对比。并予以受试者工作特征(ROC)曲线分析支气管肺泡灌洗液G试验、GM试验,在早期侵袭性真菌感染中的诊断能效。结果侵袭性肺部曲霉菌感染患者支气管肺泡灌洗液的BG浓度、I值相比对照组较高(均P<0.05)。以病理组织学诊断为金标准,支气管肺泡灌洗液G试验诊断侵袭性肺部曲霉菌感染的灵敏度、特异度、阳性预测值、阴性预测值分别为92.00%、94.00%、93.88%、88.68%。以病理组织学诊断为金标准,支气管肺泡灌洗液GM试验诊断侵袭性肺部曲霉菌感染的灵敏度、特异度、阳性预测值、阴性预测值分别为88.00%、90.00%、89.80%、88.24%。经ROC曲线分析可得:支气管肺泡灌洗液G试验与GM试验联合诊断侵袭性肺部曲霉菌感染的曲线下面积、敏感性、特异性相比单独支气管肺泡灌洗液G试验、支气管肺泡灌洗液GM试验较高,差异有统计学意义(均P<0.05)。结论支气管肺泡灌洗液G试验、GM试验均可早期诊断侵袭性肺部曲霉菌感染,且联合两项试验用于侵袭性肺部曲霉菌感染的诊断价值更高。Objective To study the diagnostic value of early diagnosis of invasive fungal infection by 1,3-traduc-d glucan assay(G test)and galactomannan assay(GM test)in bronchoalveolar lavage solution.Methods A retrospective analysis was made on 50 patients with invasive pulmonary aspergillosis admitted to the department of respiratory medicine of our hospital from June 2017 to July 2018.In addition,50 cases of bacterial infection admitted by respiratory department of our hospital during the same period were recorded as the control group.All patients were subjected to the G test of bronchoalveolar lavage fluid and the GM test,and the test results were compared.The ROC curve was also used to analyze the diagnostic efficiency of bronchoalveolar lavage fluid G test and GM test in early invasive fungal infection.Results The BG concentration and I values of bronchoalveolar lavage fluid in patients with invasive pulmonary aspergillus pneumoniae infection was higher than the control group(all P<0.05).According to the gold standard of histopathological diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of bronchial alveolar lavage fluid G test for the diagnosis of invasive pulmonary aspergillosis were 92.00%,94.00%,93.88%and 88.68%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of bronchoalveolar lavage fluid GM test for the diagnosis of invasive pulmonary aspergillosis were 88.00%,90.00%,89.80%and 88.24%,respectively based on the gold standard of histopathological diagnosis.According to ROC curve analysis,it could be seen that the area,sensitivity and specificity under the curve of G test of bronchoalveolar lavage fluid combined with GM test in the diagnosis of invasive pulmonary aspergillus infection were higher than the G test of bronchoalveolar lavage fluid alone and GM test of bronchoalveolar lavage fluid,and the difference is statistically significant(all P<0.05).Conclusion Both the G test and the GM test of bronchoalveolar lavage fl

关 键 词：侵袭性真菌感染 1 3-β-D葡聚糖 支气管肺泡灌洗液 半乳甘露聚糖 诊断价值 

分 类 号：R519[医药卫生—内科学]