荧光定量聚合酶链反应与血清半乳甘露聚糖检测在侵袭性曲霉病诊断中的价值

目的 探讨联合荧光定量聚合酶链反应(PCR)与血清半乳甘露聚糖(GM)方法用于诊断血液恶性肿瘤/造血干细胞移植患者侵袭性曲霉病(IA)的价值.方法 对80例怀疑侵袭性真菌感染的血液恶性肿瘤/造血干细胞移植患者共计205份血清标本同时进行定量PCR和血清半乳甘露聚糖的检测,根据IA诊断标准,分析定量PCR方法与GM方法的符合率及两者联合用于IA诊断时的意义.结果 5例患者确诊IA,20例临床诊断IA,34例拟诊IA,21例除外IA.定量PCR方法与GM符合率为77.5%.当定量PCR和GM同时阴性时,诊断侵袭性曲霉感染阴性预测值可达90.9%;当二者同时阳性时,阳性预测值可达100%.结论 定量PCR方法与GM方法具有良好符合率,联合两种方法有助于提高IA诊断的准确性.

Combination of real-time polymerase chain reaction assay and serum galactomannan in the diagnosis of invasive aspergillosis in patients with hematological malignancies and recipients of hematopoietic stem cell transplantation

Objective To evaluate the role of real-time polymerase chain reaction (real-time PCR) assay combined with serum galactomannan (GM) detection in the diagnosis of invasive aspergillosis(IA) with hematological malignancies or hematopoietic stem cell transplantation. Methods Eighty patients were enrolled. PCR and GM were performed simultaneously on 205 serum samples. The agreement between these two assays and the diagnostic value of the combination were analyzed. Results There were 5 proven IA ,20 probable IA,34 possible IA and 21 non-IA. Agreement between real-time PCR and GM was 77.5%. When both positive,the positive predictive value could reach 100% ;when both negative , the negative predictive value could reach 90.9%. Conclusion PCR agrees well with GM. When these two assays are combined, invasive aspergillosis can be diagnosed more accurately.