论文部分内容阅读
目的探讨血浆(1,3)-β-D-葡聚糖[(1,3)-β-D-Glucan,BDG]检测对深部真菌感染的诊断价值。方法回顾性分析430例疑似病例的BDG结果及其临床特征,应用MB-80微生物动态快速检测系统及GKT25M Set动态真菌检测试剂盒定量检测血浆中BDG的含量,结合患者血液、痰或中段尿标本的真菌培养,用统计学方法计算BDG试验在真菌感染早期诊断中的敏感性、特异性、阳性预测值和阴性预测值。同时连续检测血清BDG浓度变化,观察其与疾病进展和预后间的关系。结果 BDG检测法阳性135例,阳性率为31.4%;真菌培养法116例阳性,阳性率为26.9%。真菌培养阳性组的BDG含量为(91.85±25.26)pg/ml,真菌培养阴性组BDG含量为(30.69±10.95)pg/ml,两组血浆BDG浓度差异有统计学意义(t=2.349,P<0.05)。以真菌培养结果作标准,BDG的灵敏度为90.9%,特异性为77.4%。抗真菌治疗过程中,血清BDG水平在感染恶化患者持续升高,在治疗好转患者中明显下降。结论血浆BDG试验结果与临床侵袭性真菌诊断具有很好的一致性,与传统的真菌培养法相比,BDG检测简便、快速、阳性率高,可用于侵袭性真菌感染的早期快速诊断及疗效判断指标。
Objective To investigate the diagnostic value of plasma (1,3) -β-D-glucan [(1,3) -β-D-Glucan, BDG] in deep fungal infections. Methods The BDG results and clinical features of 430 suspected cases were retrospectively analyzed. The content of BDG in plasma was quantitatively determined by MB-80 rapid dynamic test system and GKT25M Set dynamic fungal test kit. Combined with the blood samples, sputum or middle urine samples The fungal culture was used to calculate the sensitivity, specificity, positive predictive value and negative predictive value of BDG test in the early diagnosis of fungal infection by statistical methods. At the same time, the change of serum BDG concentration was continuously monitored to observe its relationship with disease progression and prognosis. Results The BDG test was positive in 135 cases, the positive rate was 31.4%. The fungal culture method was positive in 116 cases, the positive rate was 26.9%. The positive rate of BDG in the positive group was (91.85 ± 25.26) pg / ml, while that in the fungal negative group was (30.69 ± 10.95) pg / ml. There was significant difference between the two groups (t = 2.349, P < 0.05). The results of fungal culture as a standard, BDG sensitivity of 90.9%, specificity of 77.4%. During anti-fungal treatment, serum BDG levels continued to increase in patients with worsening infection and significantly decreased in patients who improved in treatment. Conclusion The results of plasma BDG test are in good agreement with the clinical diagnosis of invasive fungi. Compared with the traditional fungal culture method, BDG is simple, rapid and positive, and can be used for the early rapid diagnosis of invasive fungal infection and indicators of curative effect .