探讨G试验、PCT、CRP、WBC联合检测对侵袭性真菌感染的鉴别诊断价值  

To explore the diagnostic value of G test,PCT,CRP and WBC in invasive fungal infection

作　　者：陈冠群 钟瑞雪[1] 霍保善[1] 黄杰 黄泽棋[1] 简咏芬 CHEN Guan-qun;ZHONG Rui-xue;HUO Bao-shan(Clinical Laboratory,Foshan Second People's Hospital Affliated to Southerm Medical University,Guangdong Foshan 528000)

机构地区：[1]南方医科大学附属佛山市第二人民医院检验科,广东佛山528000

出　　处：《医学检验与临床》2021年第9期17-21,共5页Medical Laboratory Science and Clinics

基　　金：佛山市医学科研基金资助(20200163);佛山市十三五医学重点专科建设项目(FSZDZK135026);佛山市医学重点专科培育项目(FSPY3-2015022)。

摘　　要：目的:探讨G试验、PCT、CRP、WBC联合检测对侵袭性真菌感染(Invasive Fungal Infecton,IFI)的鉴别诊断价值。方法:选取2019年3月~2020年12月佛山市第二人民医院146例疑似侵袭性真菌感染的住院患者作为研究对象,根据临床诊断将其分为IFI组与非IFI组,检测外周血中(1,3)-β-D-葡聚糖、PCT、CRP、WBC的水平。采用统计学方法分析各联合指标的诊断价值性能。结果:IFI组与非IFI组之间(1,3)-β-D-葡聚糖、PCT的结果分别为[(65.48/110.76/186.11)vs(37.5/37.5/48.9)]pg/ml,[(0.14/0.68/1.97<0.08/2.85/9.78)]ng/ml,差异具有统计学意义(P<0.05)。而两组间CRP、WBC的结果分别为(28.45/67.19/12632)vs[(17.04/74.64/129.82)]mg/ml,[(129±6.8)vs(12.6±6.7)]10/L,差异均没有统计学意义(P>0.05)。受试者工作曲线(ROC)结果显示:G试验ROC曲线下面积(AUC)为0.849,PCT的ROC曲线下面积(AUC)为0.670。再运用诊断价值四格表分析各项指标的诊断效能,G试验的诊断特异性为91.25%,灵敏度为72.70%,准确率为82.88%。PCT的诊断特异性为86.25%,灵敏度为42.42%,准确度为66.44%。采用logistic回归分析法,联合两个指标成新变量,新的变量ROC曲线下面积(AUC)为0.904,新变量各项诊断效能:特异性为98.75%,灵敏度为66.66%,准确度为84.25%。结论:G试验和PCT联合检测提高了对侵袭性真菌感染的诊断特异性和准确度。Objective:To investigate the diagnostic value of G test,PCT、CRP、WBC in invasive fiungal infection.Methods:From March 2019 to December 2020,146 inpatients suspected of invasive fungal infection in Foshan Second People's Hospital were selected as study subjects,According to the clinical diagnosis,they were divided into IFI Group and non-IFI Group.The levels of(1,3)-β-D-glucan(G test),PCT,CRP and WBC were measured in peripheral blood.The diagnostic value and perfommance index of each combined index were analyzed by statistical method Results:The levels of(1,3)-β-D-glucan and PCT were[(65.48/110.76/186.11)]vs[(37.5/37.5/48.9)]pg/ml and[0.14/0.68/1.97)vs[(0.08/2.85/9.78)]ng/ml in IFI Group and non-IFI Group,respectively.The differences were statistically significant(P<0.05).The results of CRP and WBC between the two groups were[(28.45/67.19/12632)]vs[(17.04/74.64/129.82)]mg/ml,[(12.9±6.8)vs(12.6±6.7)]10/L,respectively.The differences were not saistically significant(P>0.05).The results of receiver operating curve(ROC)showed that the area under the G test ROC curve(AUC)was 0.849,and the area under the PCT ROC curve(AUC)was 0.670.Then the diagnostic eficacy of each index was analyzed by using the diagnostic value table,the specificity,sensitivity and accuracy of G test were 91.25%,72.70%and 82.88%respectively.The diagnostic specificity,sensitivity and accuracy of PCT were 86.25%,42.42%and 66.44%respectively.Merging the two indicators into a new variable by using logistic regression analysis,the area under the new ROC curve(AUC)was 0.904.The diagnostic eficiency of the new variable was 98.75%in specificity,66.66%in sensitivity and 84.25%in accuracy.Conclusion:The specificity and accuracy of invasive fungal infection were improved by the combination ofG test and PCT.

关 键 词：侵袭性真菌感染 (1 3)-β-D-葡聚糖 降钙素原 C反应蛋白和白细胞 联合检测 

分 类 号：R73[医药卫生—肿瘤]