血清半乳甘露聚糖检测在慢性阻塞性肺疾病并发侵袭性肺曲霉病中的诊断价值

发布时间：2018-04-30 09:23

本文选题：半乳甘露聚糖 + 慢性阻塞性肺疾病　；参考：《医学研究生学报》2017年04期

【摘要】：目的目前关于血清半乳甘露聚糖(GM)检测在侵袭性曲霉感染中的诊断价值,主要集中在血液病患者、粒细胞缺乏患者中,而对慢性阻塞性肺疾病(COPD)并发侵袭性肺曲霉病(IPA)的相关研究较少。文中旨在研究在COPD并发IPA患者中血清GM实验的诊断价值。方法选取2015年3月至2016年9月在南京军区南京总医院呼吸与危重症医学科住院资料完整的COPD患者60例,其中IPA组(确诊和临床诊断IPA患者)19例,非IPA组(非IPA患者)41例。采用ELISA法检测血清GM,评价其对COPD合并IPA患者的诊断价值;同时比较IPA组7名治疗有效患者治疗前后的GM值变化。结果当血清GM取0.5为阳性界值时,其敏感性、特异性、阳性预测值、阴性预测值分别为57.9%、95.1%、84.6%、83.0%,特异性较高,但敏感性不高。7例COPD合并IPA患者治疗后GM值较治疗前有显著下降[(0.30±0.21)vs(1.48±1.37),P=0.004]。结论血清GM检测在COPD合并IPA患者中的诊断价值有限,但是血清GM动态监测有利于掌握患者病情变化。
[Abstract]:Objective to evaluate the diagnostic value of serum galactomannan in invasive aspergillus infection, mainly in patients with hematologic disease and granulocytosis. However, there were few studies on the incidence of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to study the diagnostic value of serum GM test in patients with COPD complicated with IPA. Methods from March 2015 to September 2016, 60 COPD patients with complete data of respiratory and critical care in Nanjing General Hospital of Nanjing military region were selected, including 19 patients with IPA diagnosed and clinically diagnosed in IPA group and 41 patients with non-IPA patients in non-IPA group. To evaluate the diagnostic value of ELISA in patients with COPD and IPA, and to compare the changes of GM in 7 effective patients with IPA before and after treatment. Results the sensitivity, specificity, positive predictive value and negative predictive value of serum GM were 57.9 and 84.60.The specificity was higher, but the sensitivity was not high, but the GM value of IPA patients after treatment was significantly lower than that before treatment [0.30 卤0.21)vs(1.48 卤1.37P0.004]. Conclusion Detection of serum GM is of limited diagnostic value in patients with COPD and IPA, but dynamic monitoring of serum GM is helpful to grasp the changes of patients' condition.
【作者单位】：南方医科大学金陵医院(南京军区南京总医院)呼吸与危重症医学科;
【基金】：国家自然科学基金(81330035) 国家科技部支撑计划课题(2015BAI12B00)
【分类号】：R519;R563.9

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