欢迎访问《中国真菌学杂志》杂志官方网站,今天是 分享到:

中国真菌学杂志 2012, Vol.  Issue (4): 207-210.

论著 上一篇    下一篇

血浆(1-3)-β-D-葡聚糖诊断深部真菌感染的临床研究

刘春玉, 王红, 任爱民, 杜琨, 胡岚, 李世荣, 文燕, 张淑文   

  1. 首都医科大学附属北京友谊医院感染科, 北京 100083
  • 收稿日期:2012-02-15 出版日期:2012-08-28 发布日期:2012-08-28
  • 通讯作者: 王红,E-mail:wanghong0315@yahoo.com.cn E-mail:wanghong0315@yahoo.com.cn
  • 作者简介:刘春玉,女(汉族),硕士,主治医师.E-mail:lilyliuchunyu@sohu.com

Diagnostic value of (1-3) -β-D-glucan for invasive fungal infection:a clinical research

LIU Chun-yu, WANG Hong, REN Ai-min, DU Kun, HU Lan, LI Shi-rong, WEN Yan, ZHANG Shu-wen   

  1. PeKing University hospital, Beijing 100871
  • Received:2012-02-15 Online:2012-08-28 Published:2012-08-28

摘要: 目的 探讨血浆 (1-3) -β-D-葡聚糖对早期诊断深部真菌感染的临床价值。方法 收集2009年3月~11月间在北京友谊医院感染科住院患者174例,根据侵袭性真菌感染诊断标准,将患者分为排除深部真菌组、确诊组、临床诊断组、拟诊组。应用MB-80微生物动态快速检测系统, 检测各组患者血浆 (1-3) -β-D-葡聚糖水平,分析比较深部真菌感染组和非深部真菌感染组血浆 (1-3) -β-D-葡聚糖的水平。结果 深部真菌感染组血清 (1-3) -β-D-葡聚糖含量为 (153.4±37.0) pg/mL,排除深部真菌感染组血清 (1-3) -β-D-葡聚糖含量为 (54.6±8.6) pg/mL,两组间有统计学差异 (t=3.4,P<0.01);分析血浆 (1-3)-β-D-葡聚糖诊断深部真菌感染,以20 pg/mL为诊断阈值,其准确率、敏感性、特异性、阳性预测值、阴性预测值分别为70.1%、87.5%、61.9%、52.1%、91.2%。确诊病例、临床诊断病例、拟诊病例,3组间血清(1-3)-β-D-葡聚糖含量无统计学差异 (P>0.05)。结论 深部真菌感染组的葡聚糖水平明显高于排除深部真菌感染组的葡聚糖水平,具有统计学意义。以20 pg/mL为诊断阈值,其准确率、敏感性、特异性、阳性预测值、阴性预测值分别为70.1%、87.5%、61.9%、52.1%、91.2%,可作为深部真菌感染的最佳诊断阈值。

关键词: 血浆 (1-3) -β-D-葡聚糖, 深部真菌感染, 诊断研究

Abstract: Objective To assess the clinical application of blood plasma (1-3)-β-D-glucan measurement in diagnosis of deep fungal infection.Methods One hundred and seventy-four patients were registered in Beijing Friendship hospital during 03-11,2009.According to Invasive Fungual Infection (IFI) guideline, serum (1-3) -β-D-glucan was examined routinely using Microbiology Kinetic Rapid Reader MB-80.Results The serum (1-3) -β-D-glucan value detected in deep fungal infection group was (153.4±37.0) pg/mL, whereas (54.6±8.6) pg/mL of serum (1-3) -β-D-glucan were detected in non-infection group. There was significant difference between the two groups (t=3.4,P<0.01).Applying 20 pg/mL of serum (1-3)-β-D-glucan as threshold value for diagnosis of deep fungal infection, the accuracy rate, sensitivity, specificity, positive predictive value, negative predictive values were 70.1%,87.5%,61.9%,52.1%,91.2%, respectively.The values of serum (1-3)-β-D-glucan showed no statistically significant difference among the groups (P>0.05) of confirmed cases (20.0±15.8 pg/mL), clinically diagnosed cases (181.1±74.1 pg/mL), and suspected cases (145.4±39.6 pg/mL).Conclusion With high sensitivity and specificity, serum (1-3)-β-D-glucan (>20 pg/mL) can be seen as diagnostic threshold value of deep fungal infection.

Key words: plasma (1-3) -β-D-glucan, deep fungal infections, diagnosis

中图分类号: