真菌的四种方法联合检测在肺部疾病合并IPA中的诊断价值  

Diagnostic value of combined detection of four fungal methods in pulmonary diseases with IPA

作　　者：吕莎[1] 杜月菊[2] 翟京京 孙志平[2] 李玉静[2] 吕翠环[3] LV Sha;DU Yueju;ZHAI Jingjing;SUN Zhiping;LI Yujing;LV Cuihuan(The First Department of Respiratory and Critical Care Medicine,Hebei Chest Hospital,Shijiazhuang,Hebei 050041,China;不详)

机构地区：[1]河北省胸科医院呼吸与危重症医学一科,河北石家庄050041 [2]河北省胸科医院检验科 [3]河北省胸科医院输血科

出　　处：《医学动物防制》2023年第8期727-731,共5页Journal of Medical Pest Control

基　　金：河北省医学科学研究课题计划项目(20210652)。

摘　　要：目的探讨β-D-葡聚糖(β-D-glucan,G)试验、半乳甘露聚糖(galactomannan,GM)试验、内参标化的GM试验和曲霉菌培养联合检测在诊断慢性肺部疾病合并侵袭性肺曲霉菌病(invasive pulmonary aspergillosis,IPA)患者的预测价值。方法选取2021年1月至2022年10月河北省某医院慢性肺部疾病合并IPA患者67例作为实验组,未合并IPA的患者70例作为对照组,计算上述4种试验方法及联合检测的敏感度、特异度、阳性预测值和阴性预测值,将支气管肺泡灌洗液半乳甘露聚糖(bronchoalveolar lavage fluid galactomannan,BLAF-GM)试验内参标化,使用受试者操作特征(receiver operator characteristic,ROC)曲线分析其诊断价值。结果G试验指数,实验组和对照组比较差异无统计学意义(P>0.05)。BALF-GM试验和内参标化后的BALF-GM试验指数,实验组明显高于对照组(P<0.05)。G试验、GM试验、BLAF-GM试验、内参标化的BLAF-GM试验和曲霉菌培养联合检测的敏感度、特异度、阳性预测值和阴性预测值均明显高于单独检测,其ROC曲线下面积分别为0.570、0.784、0.902、0.921和0.975。结论GM试验、BLAF-GM试验、内参标化的BLAF-GM试验和真菌培养联合检测对慢性肺部疾病合并IPA患者的早期诊断有较高的预测价值。Objective To explore the predictive value of theβ-D-glucan(G)test,galactomannan(GM)test,internal reference standardized GM test,and Aspergllus culture combined detection in the diagnosis of chronic lung disease with invasive pulmonary aspergillosis(IPA).Methods From January 2021 to October 2022,67 patients with chronic lung disease with IPA in a hospital in Heibei Province were selected as the experimental group,and 70 patients without IPA were selected as the control group.The sensitivity,specificity,positive predictive value,and negative predictive value of the above four test methods and combined detection were calculated.The internal reference of the bronchoalveolar lavage fluid galactomannan(BLAF-GM)test was standardized,and the diagnostic value of each test was analyzed using the receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in the G test index between the experimental group and the control group(P>0.05).The BALF-GM test and internal reference standardized BALF-GM test index were significantly higher in the experimental group than in the control group(P<0.05).The sensitivity,specificity,positive predictive value,and negative predictive value of the G test,GM test,BLAF-GM test,internal reference standardized BLAF-GM test,and Asperglus culture combined detection were significantly higher than those of individual detection.The areas under the ROC curve were O.570,0.784,0.902,0.921,and 0.975,respectively.Conclusion The combined detection of the GM test,BLAF-GM test,internal reference standardized BLAF-GM test,and fungal culture has high predictive value for the early diagnosis of chronic lung disease patients with IPA.

关 键 词：真菌 曲霉菌 肺泡灌洗液 真菌培养 内参 敏感度 特异度 诊断 

分 类 号：R563[医药卫生—呼吸系统]