半乳甘露聚糖在COPD患者侵袭性肺曲霉病的诊断价值

发布时间：2018-09-19 06:01

【摘要】：目的探讨痰液、支气管肺泡灌洗液(BALF)及血液半乳甘露聚糖(GM)对侵袭性肺曲霉病(IPA)的诊断价值差异。方法选择100例慢阻肺(COPD)患者,其中43例为IPA组,57例为非IPA组。半定量测定痰液、BALF及血清GM抗原,比较GM抗原对IPA诊断敏感度及特异度的差异。结果 COPD患者IPA继发感染组痰液、BALF及血清GM的A值均显著高于非IPA患者;以≥0.5为阳性界值时,痰液、BALF及血清GM敏感度、特异度、阳性预测值和阴性预测值分别为74.4%、82.4%、76.2%、81.0%;83.7%、87.7%、83.7%、87.7%;48.8%、94.7%、87.5%、71.1%。以1.0为阳性界值时,BALF和血清GM特异度、阳性预测值均达100.0%,而痰液GM特异度达91.2%,但痰液和BALF GM的敏感度和阴性预测值明显高于血清。结论痰液GM以0.5为阳性界值,对COPD患者IPA继发感染的诊断价值与BLAF相似,略优于血液,且无侵入性操作带来的痛苦,有较高的应用价值。
[Abstract]:Objective to investigate the diagnostic value of sputum, bronchoalveolar lavage fluid (BALF) and galactomannan (GM) (GM) in the diagnosis of invasive pulmonary aspergillosis (IPA). Methods A total of 100 patients with chronic obstructive pulmonary disease (COPD) were selected, of whom 43 were IPA group and 57 were non-IPA group. The sensitivity and specificity of GM antigens in diagnosis of IPA were compared by semi-quantitative determination of BALF in sputum and serum GM antigens. Results the A values of sputum and serum GM in IPA secondary infection group of COPD patients were significantly higher than those in non-IPA patients, and the sensitivity, specificity, positive predictive value and negative predictive value of sputum BALF and serum GM were 74.44.42.40.76. 2 and 83.71.087.77.87.7F87.7F88.87.70.When 鈮，

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