血清G试验在深部真菌感染中的诊断价值

目的 探讨血清1,3-β-D-葡聚糖含量测定(G试验)对深部真菌感染的诊断价值,为临床的早期诊断及个性化治疗提供可靠的依据。方法 收集2014年9月至2015年9月太和医院各临床科室高度怀疑深部真菌感染患者128例,同时进行血清G试验和真菌培养,采用统计学方法分析两种检验方法的差异。结果 血清G试验检测的阳性率57.81%(74/128)高于真菌培养阳性率46.88%(60/128),差异有统计学意义(P<0.05);真菌培养阳性患者血清中1,3-β-D-葡聚糖含量为(90.65±22.36)ng/L,健康对照者为(4.36±0.27)ng/L,差异有统计学意义(P<0.05)。采用真菌培养作为参考标准,G试验检测的敏感性、特异性、阳性预测值、阴性预测值分别为93.75%、78.30%、81.08%、92.59%。结论 血清G试验,方法简便、阳性率高、特异性高,可以辅助早期诊断深部真菌感染。

Diagnostic value of serum G test in patients with deep fungus infection

Objective To study the diagnostic value of serum 1, 3-beta-D-glucan level(G test) for deep fungus infection, so as to provide reliable basis for early diagnosis and individualized treatment. Methods 128 cases of patients with highly suspected deep fungal infections in our hospital were enrolled from Sep 2014 to Sep 2015. The serum samples were collected in all patients for G test and fungal culture, and the difference between the two test methods was statistically analyzed. Results The positive rate of serum G test(57.81%, 74/128) was significantly higher than that of fungal culture(46.88%, 60/128) (P<0.05). The concentration of serum 1, 3-beta-D-glucan in the deep fungal infection group was(90.65±22.36) ng/L, while in the normal control group it was(4.36±0.27) ng/L, with statistically significant difference(P<0.05). If defining the fungal culture as a reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of G test were 93.75%, 78.30%, 81.08% and 92.59%, respectively. Conclusion The quantitative detection of serum 1, 3-beta-D-glucan level by G test is a convenient and reliable method with higher positive rate and specificity rate, which is helpful for the early diagnosis of deep fungal infection.