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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。
OBJECTIVE: To evaluate the diagnostic value of Aspergillus galactomannan (GM) antigen for invasive pulmonary aspergillosis (IA) by enzyme linked immunosorbent assay (ELISA), to determine the appropriate positive cut-off and to evaluate the diagnostic and Guiding significance of treatment. Methods: Serum Aspergillus GM antigens were detected by ELISA in 87 high-risk IA patients. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (GMV) of GM were compared between cut-off 1.5, cut-off 1.0 and cut- Predicted value (NPV). Results: The sensitivity, specificity, PPV, NPV were 50%, 96%, 91% and 71%, respectively, at cut-off 1.5 and 65%, 92% and 87% 77%; cut-off 0.5, respectively 75%, 88%, 83% and 81%. Conclusion: Aspergillus oryzae galactomannan antigen ELISA test can be used in clinical diagnosis of invasive Aspergillus infection, with 0.5 as a turning point for the early diagnosis of great significance, is conducive to high-risk patients with Aspergillus infection decreased mortality.