真菌性鼻窦炎患者血浆1-3-β-D葡聚糖的检测及其临床意义

发布时间：2018-06-26 23:36

本文选题：真菌性鼻窦炎 + 血浆1-3-β-D葡聚糖　；参考：《中国医科大学》2008年硕士论文

【摘要】： 目的近年来,真菌性鼻窦炎的发病率随着广谱抗生素,免疫抑制剂的应用及糖尿病的多发呈逐年上升趋势,目前临床诊断主要依靠影像学检查。具有典型影像学改变的病人其诊断率较高,但对于缺乏典型影像学表现的患者临床诊断困难。术后病理组织学及真菌学检查虽然可以明确术后诊断,但对术前诊断无法提供帮助。临床诊断上的困难给治疗方案的选择以及病人的预后等带来一系列的问题,故早期、快速、准确的诊断方法对真菌性鼻窦炎的诊断及治疗方案的选择意义重大。方法采用北京金山川科技公司生产的试剂盒及MB—80微生物快速检测系统分别检测中国医科大学附属盛京医院耳鼻喉科于2007年4月至2008年2月经鼻窦内窥镜手术治疗,并经术后病理证实为真菌性鼻窦炎患者(19例为真菌球型,1例为慢性侵袭性真菌性鼻窦炎)的血液样品20例,患者年龄19岁—80岁,平均年龄51岁,采取中国医科大学附属盛京医院耳鼻喉科于2008年1月住院单纯鼻中隔偏曲患者(无鼻窦炎)的血液样品5例作为对照组,患者年龄16—56岁,平均年龄32岁(以上血样标本的采集患者均已签署知情同意书)。结果经过实验检测20例真菌性鼻窦炎(19例为真菌球型,1例为慢性侵袭性真菌性鼻窦炎)及5例对照组患者血浆中1-3-β-D葡聚糖的含量,可以发现其中18例真菌性鼻窦炎患者血浆中1-3-β-D葡聚糖的含量大于试剂盒的诊断标准10pg/ml,其中一例慢性侵袭性真菌性鼻窦炎患者血浆中1-3-β-D葡聚糖的含量达到21.82pg/ml,2例真菌性鼻窦炎患者血浆中1-3-β-D葡聚糖的含量小于10pg/ml,而对照组患者血浆中1-3-β-D葡聚糖的含量均小于10pg/ml,病例组与对照组间采用卡方检验测得卡方值为16.071,(P＜0.05)两组间有差异,有统计学意义。结论本研究共计对20例真菌性鼻窦炎(19例为真菌球型,1例为慢性侵袭性真菌性鼻窦炎)患者及5例对照组患者血浆中1-3-β-D葡聚糖进行检测,发现其中18例真菌性鼻窦炎患者血浆中1-3-β-D葡聚糖的含量大于试剂盒的诊断标准10pg/ml,实验的阳性率为90%,血浆1-3-β-D葡聚糖水平可以用于诊断真菌性鼻窦炎。血浆1-3-β-D葡聚糖的检测是一种简便、快速、实用的诊断真菌性鼻窦炎的方法。
[Abstract]:Objective in recent years, the incidence of fungal sinusitis has been increasing with the use of broad-spectrum antibiotics, immunosuppressants and diabetes mellitus. The diagnostic rate of patients with typical imaging changes is higher, but it is difficult to diagnose the patients without typical imaging findings. Although postoperative histopathology and mycology can confirm the postoperative diagnosis, it is not helpful for preoperative diagnosis. The difficulty of clinical diagnosis brings a series of problems to the choice of treatment plan and the prognosis of patients, so the early, rapid and accurate diagnosis method is of great significance to the diagnosis and treatment of fungal sinusitis. Methods the kit produced by Beijing Jinshanchuan Science and Technology Company and the MB-80 microorganism rapid detection system were used to detect the otolaryngology of Shengjing Hospital affiliated to China Medical University from April 2007 to February 2008. Endoscopic sinus surgery, The blood samples of 20 patients with mycosinusitis (19 cases with fungal bulbar type and 1 case with chronic invasive fungal sinusitis) were confirmed by postoperative pathology. The age of the patients ranged from 19 to 80 years, with an average age of 51 years. The blood samples of patients with simple nasal septum deviation (without sinusitis) were collected from Department of Otolaryngology of Shengjing Hospital affiliated to China Medical University in January 2008 as control group. The patients were aged 16-56 years. The average age was 32 years (all patients with blood samples collected had signed informed consent). Results the plasma levels of 1-3- 尾 -D glucan were measured in 20 cases of fungal sinusitis (19 cases of fungal bulbous sinusitis) and 5 cases of control group. It was found that the concentration of 1-3- 尾 -D glucan in plasma of 18 patients with fungal sinusitis was greater than the diagnostic criteria of 10 PG / ml of the kit, and that of one patient with chronic invasive fungal sinusitis was 21.82 pgml / ml of 1-3- 尾 -D glucan. The plasma levels of 1-3- 尾 -D glucan in patients with sinusitis were less than 10pg / ml, while those in the control group were less than 10pg / ml. There was significant difference between the two groups by chi-square test (P < 0.05). There is statistical significance. Conclusion the plasma levels of 1-3- 尾 -D glucan were measured in 20 patients with fungal sinusitis (19 patients with fungal bulbous sinusitis) and 5 patients with chronic invasive fungal sinusitis. It was found that the concentration of 1-3- 尾 -D glucan in plasma of 18 patients with fungal sinusitis was higher than that of the diagnostic standard of 10 PG / ml. The positive rate of the experiment was 90. The plasma level of 1-3- 尾 -D glucan could be used to diagnose fungal sinusitis. The detection of plasma 1-3-尾-D glucan is a simple, rapid and practical method for the diagnosis of fungal sinusitis.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R763

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