实时荧光定量PCR技术在侵袭性真菌感染诊断中的应用价值

发布时间：2018-02-26 10:04

本文关键词： 侵袭性真菌感染实时荧光定量PCR技术诊断　出处：《中国老年学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨实时荧光定量PCR(RTFQ-PCR)技术在侵袭性真菌感染(IFI)诊断中的应用价值。方法采集IFI高危患者102份血清,收集其相关临床资料。以"重症患者IFI的诊断和治疗指南(2007年)"作为金标准,计算RTFQ-PCR和G试验的敏感度、特异度、阳性预测值、阴性预测值。以血培养为金标准,计算RTFQ-PCR的敏感度、特异度、阳性预测值、阴性预测值。结果根据"2007年指南"的诊断标准,确诊病例2例,临床诊断病例20例,拟诊病例31例,非IFI病例49例。以确诊和临床诊断病例作为感染组,非IFI病例作为非感染组。两组年龄、慢性肾功能不全、糖尿病、预后差患者的比例比较均有统计学差异(P0.05)。IFI感染部位主要为呼吸道感染10例(50.0%)、泌尿感染8例(40.0%)、血液感染2例(10.0%)。在24例IFI患者中共分离出17株真菌,分别为9株白色念珠菌(52.9%),1株热带念珠菌(5.9%),3株光滑念珠菌(17.6%),2株念珠菌属(11.8%),2株烟曲霉(11.8%)。以"2007年指南"作为金标准,RTFQ-PCR灵敏度为50.0%,特异度为95.9%,阳性预测值为81.8%,阴性预测值为83.9%;G试验的敏感度为61.1%,特异度为91.8%,阳性预测值为73.3%,阴性预测值为86.5%。以血培养为金标准,RTFQ-PCR的敏感度为100.0%,特异度为88.2%,阳性预测值为15.4%,阴性预测值为100.0%。结论 RTFQ-PCR检测技术可以作为重症患者IFI早期诊断的一种有效手段,在临床上对IFI的早期诊断具有一定的价值。
[Abstract]:Objective to evaluate the value of real-time fluorescent quantitative PCR (RTFQ-PCR) technique in the diagnosis of invasive fungal infection (IFI). Methods 102 serum samples from high risk patients with IFI were collected. The sensitivity, specificity, positive predictive value, negative predictive value of RTFQ-PCR and G tests were calculated by using "guidelines for the diagnosis and treatment of IFI in severe patients (2007)" as gold standard. The sensitivity, specificity, positive predictive value and negative predictive value of RTFQ-PCR were calculated. 49 cases of non IFI were diagnosed and clinically diagnosed as infection group, non IFI cases as non infection group. Two groups of age, chronic renal insufficiency, diabetes mellitus, There were significant differences in the proportion of patients with poor prognosis (P 0.05). The main sites of infection were respiratory tract infection (10 cases), urinary infection (8 cases), urinary infection (n = 8) and blood infection (n = 2). 17 strains of fungi were isolated from 24 patients with IFI. Nine strains of Candida albicans 52.9 and one strain of Candida tropicalis 5.9 were found respectively. There are 3 strains of Candida smooth and 2 strains of Candida. The sensitivity of RTFQ-PCR is 50.0, the specificity is 95.9, the positive predictive value is 81.8, the negative predictive value is negative, the sensitivity of RTFQ-PCR is 50.0, the specificity is 95.9. the sensitivity of RTFQ-PCR is 50.0, the specificity is 95.9, the positive predictive value is 81.8, and the negative predictive value is negative. The sensitivity, specificity, positive predictive value and negative predictive value of blood culture were 61.1, 91.8, 73.3 and 86.5, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of blood culture were 100.0g, 88.2g, 15.4and 100.00.Conclusion the positive predictive value is 15.4, and the negative predictive value is 100.00.Conclusion RTFQ-PCR is the gold standard for RTFQ-PCR. It can be used as an effective method for the early diagnosis of IFI in severe patients. It is valuable for early diagnosis of IFI in clinic.
【作者单位】：宁夏医科大学总医院心脑血管病院ICU;宁夏医科大学;
【基金】：2015年第二批宁夏回族自治区科技支撑计划项目(No.XT201418) 宁夏医科大学2014年度校级科研项目(No.宁医校发[2014]253号)
【分类号】：R440;R519

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