HIV/AIDS合并侵袭性真菌感染GM和BG抗原检测的价值  

Value of GM and BG antigen detection in HIV/AIDS patients with invasive fungal infection

作　　者：黄宛虹 陈松林[2] 罗晓璐 刘泽端 磨立达 林英辉[2] HUANG Wanhong;CHEN Songlin;LUO Xiaolu;Liu Zeduan;MO Lida;LIN Yinghui(Department of Clinical Laboratory,Nanning Fourth People′s Hospital/Nanning Infectious Diseases Hospital Affiliated to Guangxi Medical University/Guangxi AIDS Clinical Treatment Center(Nanning),Nanning,Guangxi 530023,China;Departmen of Laboratory Teaching and Research Office,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi 530023,China)

机构地区：[1]广西壮族自治区南宁市第四人民医院/广西医科大学附属南宁市传染病医院/广西艾滋病临床治疗中心(南宁)检验科,广西南宁530023 [2]广西中医药大学第一附属医院检验教研室,广西南宁530023

出　　处：《检验医学与临床》2021年第18期2659-2662,共4页Laboratory Medicine and Clinic

基　　金：广西壮族自治区南宁市科学研究与技术开发计划项目(20183039-5);广西壮族自治区南宁市人才小高地专项资金资助项目(2018014)。

摘　　要：目的探讨半乳甘露聚糖(GM)和(1,3)-β-D-葡聚糖(BG)检测对人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)合并侵袭性真菌感染(IFI)的诊断价值。方法收集在南宁市第四人民医院住院的1333例HIV/AIDS患者的病历资料,将患者分为IFI组380例和非IFI组953例,检测患者血清GM、血浆BG水平,留取血液、痰液、灌洗液等标本行真菌培养。分析GM、BG单独及联合检测对HIV/AIDS合并IFI的诊断效能,比较IFI组和非IFI组GM、BG水平,分析患者真菌分布情况。结果GM、BG联合(并联和串联)检测的灵敏度、特异度达到86.05%、99.48%,优于GM单独检测的56.84%、88.35%及BG单独检测的66.05%、92.24%,差异均有统计学意义(P<0.05)。IFI组GM、BG水平高于非IFI组,差异均有统计学意义(P<0.05)。IFI组真菌培养以念珠菌(56.32%)及马尔尼菲篮状菌(51.84%)为主,非IFI组以念珠菌(98.25%)为主。结论HIV/AIDS合并IFI时GM、BG水平升高,二者联合检测可提高IFI的诊断效能,并可为HIV/AIDS合并IFI的早期诊治提供依据。Objective To evaluate the diagnostic value of galactomannan(GM)and(1,3)-β-D-glucan(BG)combined detection in human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients with invasive fungal infections(IFI).Methods The medical records of 1333 HIV/AIDS patients hospitalized in Nanning Fourth People′s Hospital were collected.The patients were divided into IFI group with 380 cases and non-IFI group with 953 cases.The serum levels of GM and plasma BG were detected,and the blood,sputum and lavage fluid were reserved for fungal culture.The diagnostic efficacy of single and combined detection of GM and BG in HIV/AIDS complicated with IFI was analyzed,the levels of GM and BG in IFI group and non IFI group were compared,and the distribution of fungi in patients was analyzed.Results The sensitivity and specificity of combined(parallel and series)detection of GM and BG reached 86.05%and 99.48%,which were better than 56.84%and 88.35%of GM alone detection and 66.05%and 92.24%of BG alone detection,the differences were statistically significant(P<0.05).The levels of GM and BG in the IFI group were higher than those in the non-IFI group,and the differences were statistically significant(P<0.05).The main fungal culture of the IFI group was Candida(56.32%)and Talaromyces marneffei(51.84%),and the non-IFI group was mainly Candida(98.25%).Conclusion The levels of GM and BG increase when HIV/AIDS combined with IFI.The combined detection of the two can improve the diagnostic efficiency of IFI and provide evidence for the early diagnosis and treatment of HIV/AIDS combined with IFI.

关 键 词：半乳甘露聚糖 (1 3)-β-D-葡聚糖 获得性免疫缺陷综合征 侵袭性真菌感染 

分 类 号：R512.91[医药卫生—内科学]