支气管肺泡灌洗液半乳甘露聚糖检测对非中性粒细胞缺乏患者侵袭性肺曲霉病的早期诊断价值  

The Value of Galactomannan Testing of Bronchoalveolar Lavage Fluid for the Diagnosis of Invasive Pulmonary Aspergillosis inNon-neutropenic Patients

作　　者：金欣 刘佳 左向华 丁同刚 李丽 白云石 陈建魁 JIN Xin;LIU Jia;ZUO Xianghua;DING Tonggang;LI Li;BAI Yunshi;CHEN Jiankui(Beijing Arion Cancer Hospital,Beijing 102613,China;The Fifth Medical Center,Chinese PLA General Hospital,Beijing 100071,China)

机构地区：[1]北京美中爱瑞肿瘤医院检验科,北京102613 [2]解放军总医院第五医学中心检验科,北京100071

出　　处：《标记免疫分析与临床》2024年第7期1189-1192,1218,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家高技术研究发展计划(863计划)(编号:2011AA02A111)。

摘　　要：目的探讨支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)半乳甘露聚糖(galactomannan,GM)检测在非中性粒细胞缺乏患者侵袭性肺曲霉病(invasive pulmonary aspergillosis,IPA)诊断中的价值。方法回顾性分析2014年1月至2021年12月住院并符合纳入标准的788例患者,根据EORTC/MSG诊断标准和专家共识,分为确诊IPA、临床诊断IPA、拟诊IPA和非IPA组,用统计学方法对BALF GM检测结果进行分析,比较不同阈值时BALF GM检测的灵敏度、特异性、约登指数。结果4例确诊IPA、156例临床诊断IPA为病例组,非IPA 160例为对照组。对于BALF GM检测,ROC曲线分析当cut-off≥0.935时,约登指数为0.969,是最佳的界值点,灵敏度为98.8%,特异性为98.1%。当cut-off≥1.51时,灵敏度为78.8%,特异性为100.0%。结论BALF GM检测在非中性粒细胞缺乏患者IPA诊断中具有重要意义。Objective To explore the value of galactomannan testing of bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in non-neutropenic patients.Methods A retrospective analysis was conducted in 788 patients admitted to the hospital between January,2014 and December,2021.We then determined an optimal BALF galactomannan OD cut-off value for IPA in at-risk patients.Results There were a total of 160 cases(4 proven and 156 probable IPA)and 160 controls in this study.ROC curve demonstrated an optimum OD index cut-off of 0.935,with a high specificity(98.1%)and sensitivity(98.8%)for diagnosing IPA.With a cut-off≥1.51,BALF galactomannan sensitivity and specificity for diagnosing IPA were 78.8%and 100.0%,respectively.Conclusion Our study demonstrates that BALF galactomannan testing can be a safe and useful adjunct for the diagnosis of IPA in non-neutropenic patients.

关 键 词：支气管肺泡灌洗液 侵袭性肺曲霉病 半乳甘露聚糖检测 非中性粒细胞缺乏 

分 类 号：R519[医药卫生—内科学] R563[医药卫生—临床医学]