导向鞘引导的超声支气管镜对肺真菌病的诊断价值分析

目的探究导向鞘引导的超声支气管镜(EBUS-GS)对肺真菌病的诊断价值。方法收集上海交通大学医学院附属新华医院呼吸科从2015年1月至2018年12月通过组织活检、体液或血液检查诊断为肺真菌病,并且排除肺炎、肺癌、肺脓肿、肺结核、机化性肺炎等其他疾病,经过积极抗真菌治疗后临床症状缓解、胸部CT显示病灶吸收、实验室相关检查转阴的患者。入组患者均完善气管镜、支气管肺泡灌洗液/刷检物、血液半乳甘露聚糖检测/乳胶凝集试验。根据有无行EBUS-GS检查分为EBUS-GS组和非EBUS-GS组。采用非参数检验分析EBUS-GS在肺真菌病的诊断价值。结果共纳入51例患者,EBUS-GS组20例,非EBUS-GS组31例。EBUS-GS组与非EBUS-GS组诊断率比较,差异有统计学意义(P<0.05),EBUS-GS组诊断肺真菌病阳性率更高(90.9%比48.4%)。结论 EBUS-GS有助于提高肺真菌病的诊断率,为进一步明确诊断提供依据。

Diagnostic value and analysis of endobronchial ultrasonography with a guide sheath for pulmonary fungal disease

Objective To explore the diagnostic value of endobronchial ultrasonography with a guide sheath(EBUS-GS) for pulmonary fungal disease. Methods All patients were collected from January 2015 to December 2018.They were diagnosed with pulmonary fungal disease by tissue biopsy, body fluid or blood test, and without other diseases such as pneumonia, lung cancer, lung abscess, tuberculosis, or organizing pneumonia, etc. After clinical anti-fungal treatment, clinical symptoms were relieved, chest CT lesions were absorbed, laboratory-related checks were turned negative in these patients. All patients underwent bronchoscopy, bronchoalveolar lavage fluid/brush examination, and blood galactomannan antigen test/latex agglutination test. They were divided into an EBUS-GS group and a non-EBUSGS group according to whether EBUS-GS check was performed. Non-parametric test was used to analyze the diagnostic value of EBUS-GS in pulmonary fungal diseases. Results Fifty-one patients were included and 20 patients in the EBUSGS group and 31 patients in the non-EBUS-GS group. The EBUS-GS group had a higher positive rate of pulmonary fungal disease. The diagnostic rates of the EBUS-GS group and the non-EBUS-GS group were statistically different(90.0% vs.48.4%, P<0.05). Conclusion EBUS-GS can improve the diagnosis rate of pulmonary fungal disease and provides further evidence for a clear diagnosis.