血清免疫学检验对侵袭性肺曲霉病的早期诊断价值的研究  

Research on Early Diagnostic Value of Serum Immunological Tests for Invasive Pulmonary Aspergillosis

作　　者：刘占鳌[1] 裴艳琴[1] 叶华[1] 曹雁南 LIU Zhan'ao;PEI Yanqin;YE Hua;CAO Yannan(Xi'an Medical College,Xi'an,Shaanxi 710309)

机构地区：[1]西安医学高等专科学校,陕西西安710309

出　　处：《智慧健康》2025年第5期82-84,共3页Smart Healthcare

基　　金：西安医学高等专科学校2019年度校级科研项目《免疫学及分子生物学检测技术在慢性肺曲霉病早期诊断中的应用研究》(项目编号:19Z01)。

摘　　要：目的 探讨侵袭性肺曲霉病(IPA)应用血清免疫学检验在早期诊断中的临床价值。方法 选取2023年1—12月经本院确诊的42例IPA患者作为IPA组,另选同期非IPA患者74例作为NIPA组,均行单项抗原(1,3)-β-D葡聚糖(G试验)、半乳甘露聚糖(GM)试验、烟曲霉IgG抗体检测,比较其诊断效能。结果 IPA组GM、IgG检测的阳性率均高于NIPA组(P<0.001),IPA组G试验检测阳性率与NIPA组比较,差异无统计学意义(P>0.05);G+IgG、GM+IgG、G+GM+IgG等串联检测IPA的阳性率均比NIPA高(P<0.05),但G+GM检测IPA的阳性率与NIPA比较,差异无统计学意义(P>0.05);单独检测中,GM、IgG试验的阳性预测值在三项当中占比最高,均为90%左右;联合检测中,G、GM及IgG三者串联的Kappa为0.860,表示一致性很高;三者并联的Kappa为0.533,表示一致性较高。结论 GM、IgG可作为临床诊断的首选,三者串联检测可以提升检出率(特异性较高),早期筛查中可应用并联检测。Objective To investigate the clinical value of serum immunological test in the early diagnosis of invasive pulmonary aspergillosis (IPA).Methods 42 patients with IPA diagnosed in our hospital from January 2023 to December 2023 were selected as the study objects,and 74 patients with non-IPA (NIPA) during the same period were selected as the control group.All patients underwent single antigen (1,3)-β-D glucan (G test),galactomannan (GM) test and IgG antibody detection of Aspergillus fumigatus.The diagnostic efficiency was compared.Results The positive rate of IPA detected by GM and IgG was higher than that by NIPA (P< 0.001).There was no significant difference between the positive rate of IPA detected by G test and NIPA (P> 0.05).The positive rate of IPA in tandem detection by G+IgG,GM+IgG,and G+GM+IgG was higher than that of NIPA (P<0.05),but there was no significant difference between the positive rate of IPA detected by G+GM and NIPA (P>0.05).The positive predictive values of GM and IgG tests were the highest among the three tests,both of which were about 90%.In the combined detection,the kappa of G,GM and IgG in tandem was 0.860,indicating high consistency.The kappa of the three in parallel is 0.533,indicating high consistency.Conclusion GM and IgG can be used as the first choice for clinical diagnosis.Tandem detection of the three can improve the detection rate (high specificity),and parallel detection can be used in early screening.

关 键 词：G试验 GM试验 烟曲霉IgG抗体 侵袭性肺曲霉病 

分 类 号：R446.6[医药卫生—诊断学]