GM、G试验及真菌培养鉴定对肺部侵袭性真菌感染的诊断价值

发布时间：2018-04-16 20:25

本文选题：肺真菌感染 + 肺泡灌洗液　；参考：《军事医学》2016年03期

【摘要】：目的检测疑诊为肺部侵袭性真菌感染(IFI)患者的支气管肺泡灌洗液(BALF)和血清半乳甘露聚糖(galacto-mannan,GM)、血清(1,3)-β-D葡聚糖[(1,3)-beta-D-glucan,G test]并对BALF进行真菌培养鉴定,评估上述实验诊断方法对临床深部真菌感染的诊断效率。方法回顾性分析148例IFI疑诊患者,总结血清/BALF GM、血清G试验和真菌培养结果,分别评估其敏感性、特异性、阳性预测值、阴性预测值和联合检测对IFI的诊断价值。结果 148例病例中临床诊断为IFI有48例,临床排除100例,在48例IFI患者中,血清GM阳性3例,BALF GM阳性25例,G试验阳性31例,真菌培养阳性30例。联合检测敏感性91.6%、特异性70.0%、阳性预测值59.5%、阴性预测值94.6%,联合检测大幅度提高了其诊断敏感性。结论联合检测GM、G试验和真菌培养鉴定能提高IFI诊断敏感性,对肺部IFI具有较好的诊断价值。
[Abstract]:Objective to detect the bronchoalveolar lavage fluid (BALFF), galacto-mannanus (GMN) and 尾 -D-glucanG test (尾 -D-glucanG test) of patients suspected of pulmonary invasive fungal infection (IFI), and to identify the fungal culture of BALF.To evaluate the diagnostic efficiency of the above methods for clinical deep fungal infection.Methods 148 patients with suspected IFI were analyzed retrospectively. The results of serum / BALF GMs, serum G test and fungal culture were analyzed. The sensitivity, specificity, positive predictive value, negative predictive value and combined detection were evaluated for the diagnosis of IFI.Results among 148 cases, 48 cases were diagnosed as IFI and 100 cases were clinically excluded. Among 48 cases of IFI, 3 cases were positive for serum GM and 31 cases were positive for G test, and 30 cases were positive for fungal culture.The sensitivity, specificity, positive predictive value and negative predictive value were 91.6%, 70.0%, 59.5% and 94.6%, respectively.Conclusion combined detection of GMM-G and fungal culture can improve the sensitivity of IFI diagnosis and have a good diagnostic value for pulmonary IFI.
【作者单位】：安徽医科大学解放军307临床学院;军事医学科学院附属医院检验科;
【基金】：国家科技重大专项资助项目(2013ZX10004203) 国家重大科学仪器设备开发专项(2012YQ18011708)
【分类号】：R519

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