支气管肺泡灌洗液对免疫功能正常肺曲霉病患者的早期诊断价值

发布时间：2018-07-12 19:28

本文选题：支气管镜检查 + 支气管肺泡灌洗液　；参考：《中国内镜杂志》2017年11期

【摘要】：目的探讨支气管肺泡灌洗液(BALF)对免疫功能正常患者肺曲霉病的早期诊断价值,并了解支气管肺泡灌洗术操作方法对半乳甘露聚糖(GM)试验的影响,初步探讨建立统一的检测肺泡灌洗液GM试验的支气管肺泡灌洗术及取样操作方法与流程。方法对2016年1月-2017年2月因肺部感染在该院呼吸内科诊治的患者84例,进行BALF收集。按照收集灌洗液顺序前后收集2管送检GM实验,根据结果病例组及对照组内均分为GM1及GM2亚组。根据诊断标准及分级制度,将患者分为病例组22例(包括确诊2例、临床诊断7例、拟诊13例)以及对照组62例。统计并分析病例组和对照组的GM试验结果。结果 GM1与GM2组检测的GM-I值有明显差异,且GM1的I值平均秩较高(Z=-3.98,P=0.000)。BALF-GM1界限值0.60,诊断效率最高。敏感度86.36%,特异度93.55%,阳性预测值82.61%,阴性预测值95.08%。BALFGM1的曲线下面积(0.941)明显高于BALF-GM2(0.798)。结论支气管肺泡灌洗术中收集BALF的操作顺序对BALF-GM试验I值大小存在影响,送检第1管肺泡灌洗液BALF-GM试验对肺曲霉病诊断具有更高的应用价值。
[Abstract]:Objective to investigate the value of bronchoalveolar lavage fluid (BALF) in the early diagnosis of pulmonary aspergillosis in patients with normal immune function, and to understand the effect of bronchoalveolar lavage on galactomannan (GM) test. To establish a unified bronchoalveolar lavage technique for the detection of alveolar lavage fluid GM test and the sampling procedure. Methods 84 patients with pulmonary infection from January 2016 to February 2017 were collected by BALF. According to the collection of lavage fluid before and after the collection of two tubes for GM test, according to the results of the case group and the control group were divided into GM1 and GM2 subgroup. According to the diagnostic criteria and grading system, the patients were divided into two groups (including 2 cases of diagnosis, 7 cases of clinical diagnosis and 13 cases of planned diagnosis) and 62 cases of control group. The GM test results of case group and control group were statistically analyzed. Results there was significant difference between GM1 and GM2 group in GM-I, and the average rank of GM1 was higher (ZAL-3.98 Pu 0.000). BALF-GM1 was 0.60, and the diagnostic efficiency was the highest. Sensitivity 86.36, specificity 93.55, positive predictive value 82.61, negative predictive value 95.08.BALFGM1 (0.941) was significantly higher than BALF-GM2 (0.798). Conclusion the order of BALF collection during bronchoalveolar lavage has an effect on the size of BALF-GM test I, and the BALF-GM test in the first tube of alveolar lavage fluid has a higher application value in the diagnosis of pulmonary aspergillosis.
【作者单位】：北京大学深圳医院呼吸内科;
【分类号】：R519

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