血浆1,3-β-D葡聚糖测定在肺部真菌感染诊断中的应用

目的总结临床方面资料研究血浆1,3-β-D葡聚糖测定在肺部真菌感染诊断中的应用效果。方法选择某院自2009年6月～2010年2月所收治的血液科、呼吸内科、ICU及神经内科住院患者98例,均为肺部感染。将其分成用药组与非用药组,依据中华医学会制定的"肺真菌病诊断"为诊断标准,对两组患者行血浆1,3-β-D葡聚糖测定即(G试验,正常参考值为小于10pg/ml)。比较两组的血浆1,3-β-D葡聚糖值,同时行痰真菌涂片,后比较这两种测定方法的特异与灵敏性,同时再比较阴性与阳性预测值,以此评定血浆1,3-β-D葡聚糖测定效果。对测定后高于正常值,则需要给予患者行抗菌治疗,治疗时间为6～11d,后行复查。结果非用药组的血浆1,3-β-D葡聚糖值明显高于用药组(P﹤0.05)。经G试验与痰真菌涂片测定后,G试验的灵敏与特异性及阴性和阳性预测值都要明显高于痰真菌涂片,差异有统计学意义(P﹤0.05)。结论血浆1,3-β-D葡聚糖测定在肺部真菌感染诊断中具有非常重要的价值。

Plasma 1,3-beta-D glucan assay in the diagnosis of pulmonary fungal infection

OBJECTIVE To summarize the clinical data to study the plasma levels of 1,3 beta-D glucan assay in diagnosis of pulmonary fungal infection in the application effect.METHODS We collected 98 patients were selected in hematology department,respiratory department,ICU and neurology from 2009 June-2010 February,all of them were pulmonary infection.They were divided into intervention and control group,according to Chinese Medical Association to develop the’pulmonary fungal disease diagnosis’criteria for diagnosis,we performed detection for the plasma 1,3-beta-D glucan content in the two groups(G test,normal reference values for less than 10pg/ml).We compared the plasma 1,3-beta-D dextran value of the two groups,and sputum fungal smear,after comparing the two methods of determining the specificity and sensitivity,as well as comparative and positive and negative predictive values.In order to assess plasma 1,3-beta-D dextran determination effect.On the determination of higher than normal,it needs to be given to patients with antimicrobial treatment,treatment time was 6-11d after review.The results of drug plasma 1,3-beta-D dextran was significantly higher than that of the medication group(P﹤0.05).After the G test and sputum fungal smear assay,G test sensitivity and specificity and negative and positive predictive values were significantly higher than sputum fungal smear,there was significantly difference(P﹤0.05).CONCLUSION Plasma 1,3-beta-D glucan assay in diagnosis of pulmonary fungal infection had very important value and significance.