摘要
目的探讨应用血浆1,3-β-D葡聚糖（BG）用于诊断卡氏肺孢子菌肺炎的临床价值。方法选取确诊卡氏肺孢子菌肺炎（PCP）的患者50例,卡氏肺孢子菌（PC）定植的患者50例及同期非PC定植的患者50例,检测其血浆中的BG浓度。结果 PCP患者血浆BG的中位数是698.5pg/mL[四分位距（IQR）：184.4-1 256.0pg/mL],高于PC定植患者和非PC定植患者的血浆BG中位数66.5pg/mL（IQR：50.0-91.0pg/mL）、135.9pg/mL（IQR：54.0-556.3pg/mL）。PCP患者血浆BG的平均水平是（1 022.8±982.6）pg/mL,明显高于PC定植[（74.7±33.6）pg/mL]和非PC定植[（562.7±934.9）pg/mL]患者血浆BG的平均水平,差异有统计学意义（P〈0.05）。以151.5pg/mL为阳性临界值时,血浆BG诊断PCP的敏感性、特异性、阳性预测值和阴性预测值分别是96.0%、74.0%、64.9%和97.4%。以血浆BG作为PCP的诊断方法时,AUC为0.89。结论血浆BG可以作为PCP的一个早期诊断指标,同时可以根据BG结果鉴别PCP或PC定植。
Objective To explore the clinical value of plasma 1,3-β-D glucan in the diagnosis of Pneumocystis carinii pneumonia（PCP）.Methods 50 patients with PCP,50 patients with Pneumocystis carinii（PC）colonization and contemporaneous 50 patients without PC colonization were recruited as the study subjects and tested for plasma 1,3-β-D glucan（BG）.Results Median plasma BG in the PCP patients was 698.5pg/mL[interquartile range（IQR）：184.4-1 256.0pg/mL],which was higher than 66.5pg/mL（IQR：50.0-91.0pg/mL）in the PC colonization and135.9pg/mL（IQR：54.0-556.3pg/mL）in the PC noncolonization patients,respectively.The average level of plasma BG in the PCP patients was（1 022.8±982.6）pg/mL,which was also higher than（74.7±33.6）pg/mL and（562.7±934.9）pg/mL in the PC colonization and PC noncolonization patients,respectively.The difference of the average levels among three groups was statistically significant（P〈0.05）.With 151.5pg/mL as the positive critical value,the sensitivity,specificity,positive and negative predictive values of plasma BG for diagnosing PCP were96.0%,74.0%,64.9% and 97.4% respectively.With plasma BG as the diagnostic method of PCP,the area under the curve（AUC）of receiver operating characteristic（ROC）curve was 0.89.Conclusion The plasma BG can be used as an early diagnostic indicator of PCP,which also can differentiate PCP from PC colonization.
出处
《检验医学与临床》
CAS
2015年第22期3337-3338,3341,共3页
Laboratory Medicine and Clinic
