1,3-β-D-葡聚糖检测对自身免疫性疾病合并侵袭性肺真菌病的诊断价值

发布时间：2018-01-30 08:38

本文关键词： 自身免疫性疾病侵袭性肺真菌病诊断 -β-D-葡聚糖　出处：《中国呼吸与危重监护杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的评价1,3-β-D-葡聚糖检测(G试验)对自身免疫性疾病合并侵袭性肺真菌的诊断价值。方法回顾性研究郑州大学第一附属医院2014年1月至2016年1月临床诊断为自身免疫性疾病,在免疫抑制治疗过程中合并肺部感染的住院患者372例,根据侵袭性肺部真菌感染的诊断标准和治疗原则(草案)(其中G试验不作为诊断标准),分为自身免疫性疾病合并侵袭性肺真菌及自身免疫性疾病合并非侵袭性肺真菌病。自身免疫性疾病合并侵袭性肺真菌病患者分为:确诊(18例),临床诊断(35例),拟诊(70例),将确诊和临床诊断患者作为病例组(53例),自身免疫性疾病合并非侵袭性肺真菌患者作为对照组(249例),分析两组1,3-β-D-葡聚糖的水平及对自身免疫性疾病合并侵袭性肺真菌病的诊断价值。结果自身免疫性疾病合并侵袭性肺真菌患者的1,3-β-D-葡聚糖水平明显高于自身免疫性疾病合并非侵袭性肺真菌患者(P0.05)。应用受试者工作特征(ROC)曲线进行分析发现G试验对自身免疫性疾病合并侵袭肺真菌患者具有较高的诊断价值(ROC曲线下面积为0.83),在1,3-β-D-葡聚糖=93.8 pg/ml时其诊断的敏感性、特异性、阳性预测值、阴性预测值分别为0.65(95%置信区间0.56~0.73)、0.87(95%置信区间0.83~0.92)、0.70(95%置信区间0.64~0.81)、0.83(95%置信区间0.79~0.88)。结论 G试验对自身免疫性疾病合并侵袭性肺真菌病的诊断具有重要价值。
[Abstract]:Objective to evaluate 1. 3- 尾 -Dglucan test). Methods the clinical diagnosis of autoimmune diseases with invasive pulmonary fungi from January 2014 to January 2016 in the first affiliated Hospital of Zhengzhou University was retrospectively studied. 372 inpatients with pulmonary infection during immunosuppressive therapy according to the diagnostic criteria and treatment principles of invasive pulmonary fungal infection (G test is not used as diagnostic criteria). The patients were divided into autoimmune diseases with invasive pulmonary fungi and autoimmune diseases with noninvasive pulmonary mycosis. Patients with autoimmune diseases complicated with invasive pulmonary mycosis were divided into 18 cases. 35 cases were diagnosed clinically, 70 cases were diagnosed, 53 cases were diagnosed and 53 cases were diagnosed, and 249 cases of autoimmune diseases complicated with noninvasive pulmonary fungi were used as control group. To analyze the level of 1t3- 尾 -D- glucan and its diagnostic value in patients with autoimmune diseases complicated with invasive pulmonary mycosis. The level of 3- 尾 -Dglucan was significantly higher than that of non-invasive pulmonary fungi patients with autoimmune diseases. Curve analysis showed that G test had a high diagnostic value for patients with autoimmune diseases complicated with pulmonary fungi. The area under the ROC curve was 0.83). The diagnostic sensitivity, specificity and positive predictive value of 3- 尾 -D- glucan were 93.8 pg/ml. The negative predictive values were 0.65 ~ 95% confidence interval 0.56 ~ 0.73 ~ 0.87 ~ 95% confidence interval 0.83 ~ 0.92). 0.70% 95% confidence interval 0.64% 0.81). Conclusion G test is of great value in the diagnosis of autoimmune diseases with invasive pulmonary mycosis.
【作者单位】：郑州大学第一附属医院呼吸与重症学科;郑州大学第一附属医院病理科;
【基金】：河南省科技厅基础与前沿技术研究项目(142300410327)
【分类号】：R519;R593.2
【正文快照】： 自身免疫性疾病(AD)是由于多种原因造成机体免疫功能紊乱,使机体自身免疫效应细胞如T淋巴细胞、B淋巴细胞、自然杀伤细胞、巨噬细胞等对自身组织或细胞产生病理性免疫应答反应,从而引起组织、器官功能损害的一种疾病。随着对自身免疫性疾病发病机制的深入研究,临床治疗方法也

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