摘要
目的:评价血清1,3-β-D葡聚糖(G)和半乳甘露聚糖(GM)抗原联合检测对血液肿瘤患者侵袭性真菌感染(IFI)的早期诊断价值。方法:42例中性粒细胞减少伴发热,经广谱抗生素治疗无效的血液病患者,根据临床回顾性诊断标准定义阳性和阴性病例。采用ELISA试剂盒检测患者血清G和GM,分别计算GM试验和G试验及联合检测的灵敏度、特异度、阳性和阴性预测值。结果:以I值>1.0为GM试验阳性,G浓度>60 pg/L为G试验阳性计算,GM试验和G试验联合检测的灵敏度、特异度、阳性和阴性预测值77.8%,90.3%,82.4%,87.5%;G试验的灵敏度和阳性预测值高,但GM试验的特异度高。结论:GM试验和G试验联合检测提高试验的敏感度,减少了假阴性的发生,对早期诊断IFI有一定的临床意义。
Objective：To evaluate the value of serum galactomannan （GM） enzyme immunoassay combine with 1, 3 beta-glucan （G） assay for diagnosis of invasive fungal infection （IFI） in hematological disorders. Method.. Blood samples were obtained from 42 patients with neutropenic hematological disorder, fever and shown no response to broad-spectrum antibiotics therapy. Serum concentration of GM and G were detected by enzyme linked immunosorbent assay. The proven IFI and non-IFI patients were defined by retrospective clinical analysis according to domestic IFI diagnostic criteria. Result：GM positive was defined as I index〉1. 0 and G positive was defined as G〉60 ng/L, The sensitivity an specificity of both GM and G assay were 77.8% and 90.3% and the positive and negative predictive values were 82.4% and 87.5% respectively. The performance of G-based diagnosis appears to be better for sensitivity. GM assay was shown to have a higher specificity than BG assay. Conclusion..Serum GM enzyme immunoassay combine with 1, 3 beta-glucan （G） assay for diagnosis of IFI in hematological disorders increased sensitivity of detecting IFI and decreased false negative cases, and it could be a more reliable method for early diagnosis of IFI.
出处
《临床血液学杂志》
CAS
2009年第3期253-255,共3页
Journal of Clinical Hematology
基金
深圳市科技局项目资助(No:200703211)
