摘要
目的探讨不同部位深部真菌感染时血清(1,3)-β-D葡聚糖(BDG)的阈值并评价其临床意义。方法 2014年至2015年,收集侵袭性真菌感染(IFI)患者资料并按感染部位不同分为三组,分别是血流真菌感染患者27人,肺部真菌感染患者34人及泌尿系统真菌感染患者20人,选取同时期非真菌感染患者100人作为对照组,回顾性分析三组IFI患者及对照组患者血清BDG检测结果,根据ROC曲线评价三组感染部位不同的患者BDG阈值的差异。结果血流真菌感染组,肺部真菌感染组及泌尿系统真菌感染组的BDG均值分别为236.85pg/ml,206.95pg/ml,122.92pg/ml,对照组BDG均值为20.14pg/ml,三组真菌感染患者BDG浓度与非真菌感染组的差异均有统计学意义(P值均<0.01);三组真菌感染组之间的统计学分析显示,血流真菌感染组与肺部真菌感染组间BDG浓度差异无统计学意义(P值>0.05),但泌尿系统真菌感染组与血流及肺部真菌感染组间BDG浓度差异有统计学意义(P<0.01)。根据ROC曲线,血流、肺部及泌尿系统诊断真菌感染的阈值分别为92.68、76.32和77.85pg/ml时,其敏感性和特异性达到最佳状态。结论 BDG是诊断深部真菌感染的良好指标,采用BDG浓度协助诊断泌尿系统真菌感染应适当提高阈值标准。
Objective To investigate the diagnostic threshold of serum level of（1,3）-β-D-gulcan（BDG）for the invasive fungal infection（IFI）patients.Methods Collect the information of IFI patients from 2014 to 2015 and divided them into three groups.The three groups are 27 patients with blood fungal infection,34 patients with lung fungal infection and 20 patients with urinary system fungal infection.Collect 100 non-IFI patients and set them as contraol group in the same time.Analyze the serum BDG level of all the patients retrospectively,draft ROC curve to analyze the optimal diagnostic value of BDG for diagnosis of the three different organ IFI.Results The average BDG concentration of blood fungal infection,lung fungal infection,urinary system fungal infection and the control group were 236.85 pg/ml,206.95 pg/ml,122.92 pg/ml and 20.14 pg/ml respectively.indicating the BDG concentration value in the three IFI groups were significantly higher than the control group（P〈0.01）.according to the statistical analysis,the BDG concentration value of urinary system fungal infection groups were significantly lower than the other two groups,（P〈0.01）.while the BDG concentration of blood fungal infection and the lung fungal infection had no significant difference（P〉0.05）.According to the ROC curve,the optimal diagostic threshold of blood fungal infection,lung fungal infection and urinary system fungal infection were 92.68、76.32 amd 77.85 pg/ml.Conclusion serum BDG can be regarded as a good diagnostic indicator of IFI.The dianostic threshold of urinary system fungal infection should be enhanced properly.
作者
任丽娟
郑文亮
李智
REN Li-juan;ZHENG Weiliang;LI Zhi(Xuchang Central Hospital Clinical Laboratory,Xuchang 461000,China)
出处
《中国实验诊断学》
2018年第11期1888-1890,共3页
Chinese Journal of Laboratory Diagnosis
基金
许昌市备案科技计划项目(编号20170213264)
关键词
ROC曲线
侵袭性真菌感染
(1
3)-β-D葡聚糖
阈值
Receiver operating characteristic curve
Invasive fungal infection
（1,3）-β-D-gulcan
Threshold value
