G试验和GM试验对慢性阻塞性肺疾病急性加重期患者侵袭性肺真菌感染的早期诊断价值

发布时间：2018-05-14 16:27

本文选题：慢性阻塞性肺疾病 + -β-D葡聚糖　；参考：《广东医学》2014年17期

【摘要】：目的评价G试验和GM试验对慢性阻塞性肺疾病急性加重期(AECOPD)患者侵袭性肺真菌感染(IPFI)的早期诊断价值。方法收集79例AECOPD高危IPFI患者,其中临床确诊45例,拟诊6例,非IPFI 28例。分别检测患者血浆1,3-β-D葡聚糖水平(G试验)和血清半乳甘露聚糖水平(GM试验)值,以1,3-β-D葡聚糖水平大于10 ng/mL为G试验阳性,以半乳甘露聚糖水平0.5为GM试验阳性。分别计算G试验、GM试验及联合检测的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)。结果 G试验的敏感度为60.0%,特异度为35.7%,PPV为60.0%,NPV为35.7%;GM试验的敏感度为13.3%,特异度为75.0%,PPV为46.2%,NPV为65.0%。G试验的敏感度高于GM试验,而特异度低于GM试验。联合检测一敏感度可达64.4%,联合检测二特异度可达96.4%,PPV为54.7%,NPV为39.7%,其敏感度和特异度均高于G试验、GM试验单独检测。结论 G试验和GM试验联合检测,能提高诊断准确性,减少假阳性或假阴性的发生,为AECOPD患者IPFI的早期快速诊断提供有效实验室依据。
[Abstract]:Objective to evaluate the value of G test and GM test in the early diagnosis of invasive pulmonary fungal infection (IPFI) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Seventy-nine patients with high risk IPFI of AECOPD were collected, of whom 45 were clinically diagnosed, 6 were suspected to be diagnosed and 28 were non-IPFI. The plasma level of 1t3- 尾 -D-glucan (G test) and serum galactomannan level (GM-test) were measured respectively. The G test was positive with 1t3- 尾 -D-glucan level greater than 10 ng/mL, and the GM test was positive with galactomannan level 0. 5. The sensitivity, specificity, positive predictive value and negative predictive value of G-test GM test and combined test were calculated respectively. Results the sensitivity of G test was 60. 0, the specificity of PPV was 60. 0. The sensitivity of GM test was 13. 3, and the specificity was 75. 0. The sensitivity of NPV was 46. 2%. The sensitivity of G test was higher than that of GM test, and the specificity was lower than that of GM test. The sensitivity and specificity of combined detection were 64.4 and 96.4respectively, and the NPV of PPV was 54.7 and 39.7.The sensitivity and specificity were higher than that of G test and GM test alone. Conclusion the combined detection of G test and GM test can improve the diagnostic accuracy and reduce the occurrence of false positive or false negative. It provides an effective laboratory basis for the early rapid diagnosis of IPFI in AECOPD patients.
【作者单位】：广州医科大学附属第一医院、广州呼吸疾病研究所、呼吸疾病国家重点实验室呼吸科;
【分类号】：R519;R563.9

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