微生物检验在肺曲菌病患者诊治中的价值研究  

Study on the value of microbiological tests in the diagnosis and treatment of patients with pulmonary aspergillosis

作　　者：谢琰琰 王国磊[1] XIE Yan-yan;WANG Guo-lei(Zaozhuang Municipal Hospital,Zaozhuang 277100,China)

机构地区：[1]枣庄市立医院,277100

出　　处：《中国现代药物应用》2022年第18期89-93,共5页Chinese Journal of Modern Drug Application

摘　　要：目的探究微生物检验在肺曲霉菌病(PA)患者诊治中的应用价值。方法选择152例PA患者作为研究对象,其中寄生性肺曲菌病(PPA)患者63例、过敏性肺曲菌病(APA)患者57例、侵袭性肺曲菌病(IPA)患者32例。所有患者均采用半乳糖甘露醇聚糖抗原检测(GM试验)、真菌(1,3)-β-D葡聚糖检测(G试验)以及痰培养检测法进行检测。对比三种亚型患者不同检测方法阳性率及临床症状,分析三种亚型患者治疗措施及预后效果。结果PPA、APA、IPA患者GM试验的阳性率分别为77.78%、77.19%、81.25%,高于G试验的60.32%、59.65%、56.25%与痰培养的58.73%、56.14%、53.13%,差异具有统计学意义(P<0.05);且PPA、APA、IPA患者联合检验的阳性率分别为85.71%、89.47%、87.50%,高于G试验与痰培养,差异具有统计学意义(P<0.05)。PPA、APA、IPA患者联合检验的阳性率略高于GM试验,但差异无统计学意义(P>0.05)。PPA患者的发热、咳嗽、咯血、胸闷、肺啰音发生率分别为9.52%、36.51%、76.19%、39.68%、6.35%,APA患者的发热、咳嗽、咯血、胸闷、肺啰音发生率分别为49.12%、59.65%、56.14%、59.65%、50.88%,IPA患者的发热、咳嗽、咯血、胸闷、肺啰音发生率分别为75.00%、100.00%、34.38%、81.25%、84.38%。PPA患者症状多表现为咳嗽、咯血、胸闷,APA患者症状多表现为咳嗽、咯血、胸闷、肺啰音,而IPA患者症状多表现为发热、咳嗽、胸闷、肺啰音。IPA患者的发热、咳嗽、胸闷、肺啰音发生率高于APA、PPA患者,APA患者的发热、咳嗽、胸闷、肺啰音发生率高于PPA患者,PPA患者咯血发生率高于APA、IPA患者,APA患者咯血发生率高于IPA患者,差异有统计学意义(P<0.05)。PPA患者85.71%采用手术治疗,APA患者87.72%采用药物治疗,IPA患者100.00%采用药物治疗。治疗后,三种亚型患者的治疗效果均较好,PPA治愈率为95.24%,APA治愈率为92.98%,IPA治愈率为90.63%。结论微生物检验在PA患者中具备�Objective To investigate the application value of microbiological tests in the diagnosis and treatment of patients with pulmonary aspergillosis(PA).Methods 152 patients with PA were selected for the study,including 63 patients with parasitic pulmonary aspergillosis(PPA),57 patients with allergic pulmonary aspergillosis(APA),and 32 patients with invasive pulmonary aspergillosis(IPA).All patients were tested by galactomannan antigen test(GM test),the fungal(1,3)-β-D glucan test(G test),and the sputum culture assay.The positive rates of different testing methods and clinical symptoms of patients with the three subtypes were compared,and the treatment measures and prognostic effects of patients with the three subtypes were analyzed.Results The positive rates of GM test in patients with PPA,APA,and IPA were 77.78%,77.19%,and 81.25%,which were higher than 60.32%,59.65%,56.25%of G test and 58.73%,56.14%,53.13%of sputum culture assay,and the differences were statistically significant(P<0.05).The positive rates of the combined test in patients with PPA,APA,and IPA were 85.71%,89.47%,and 87.50%,which were higher than those of G test and sputum culture assay,and the differences were statistically significant(P<0.05).The positive rate of the combined test in patients with PPA,APA,and IPA was slightly higher than that of the GM test,but the difference was not statistically significant(P>0.05).The incidences of fever,cough,hemoptysis,chest tightness,and pulmonary rales in patients with PPA were 9.52%,36.51%,76.19%,39.68%,and 6.35%;the incidences of fever,cough,hemoptysis,chest tightness,and pulmonary rales in patients with APA were 49.12%,59.65%,56.14%,59.65%,and 50.88%;the incidences of fever,cough,hemoptysis,chest tightness,and pulmonary rales in patients with IPA were 75.00%,100.00%,34.38%,81.25%,and 84.38%.Patients with PPA showed more symptoms of cough,hemoptysis and chest tightness,while patients with APA showed more symptoms of cough,hemoptysis,chest tightness and pulmonary rales,while patients with IPA showed more sym

关 键 词：微生物检验 肺曲霉菌病 临床诊治 应用价值 

分 类 号：R519[医药卫生—内科学] R446.5[医药卫生—临床医学]