曲霉半乳甘露聚糖检测对侵袭性曲霉病早期诊断的实验研究

目的：评价酶联免疫吸附试验（ELISA）检测曲霉半乳甘露聚糖（GM）抗原对侵袭性肺曲霉病（IA）的诊断价值,确定合适的阳性界值（cut-off）及对诊断和治疗的指导意义。方法：采用ELISA方法检测87例IA高危患者的血清曲霉GM抗原,比较cut-off 1.5、cut-off 1.0、cut-off 0.5时GM检测的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）。结果：cut-off 1.5时,ELISA检测的敏感性、特异性、PPV、NPV分别为50%、96%、91%和71%;cut-off 1.0时分别为65%、92%、87%和77%;cut-off 0.5时分别为75%、88%、83%和81%。结论：曲霉菌半乳甘露聚糖抗原ELISA检测可用于临床诊断侵袭性曲霉菌感染,以0.5为折点对早期诊断很有意义,有利于高危患者曲霉感染病死率的降低。

The Study on Early Diagnosis of Invasive Aspergillosis by the Detection of Galactomanan

Objective:To assess the diagnosis value of enzyme-linked immunosorbent assay(ELISA) in detecting aspergillus galactomannan(GM) antigen in patients with invasive pulmonary aspergillosis.Methods:ELISA was performed to serially screen for aspergillus GM antigen from 87 patients.Sensitivity,specificity and predictive values were compared with in different cut-off.Results:The sensitivity,specificity,positive predictive value and negative predictive value were 50%,96%,91% and 71% respectively for cut-off 1.5,65%,92%,87% and 77% for cutoff 1.0,75%,88%,83% and 81% for cut-off 0.5.Conclusions:The detection of serum aspergillus GM antigen can be useful for early diagnosis of invasive aspergillosis.