摘要
目的:以侵袭性肺部真菌感染患者(IPFI)为例,分析血清、肺泡灌洗液(1-3)-β-D葡聚糖检测[(1-3)-serum β-D test, G]试验、半乳甘露聚糖检测(GM)试验在其早期诊断中的应用价值。方法:选取53例IPFI患者作为IPFI组;另选取同期就诊的53例肺部细菌感染患者作为对照组。所有患者均行血清和肺泡灌洗液G试验、GM试验检测。比较两组患者的检测结果,分析血清和肺泡灌洗液G试验、GM试验的诊断价值。结果:两组患者的血清G试验、GM试验和肺泡灌洗液G试验、GM试验检测结果比较,差异均有统计学意义(P<0.05);以组织病理学检查结果为金标准,血清G试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为69.81%、100.00%、84.91%、100.00%和76.81%;血清GM试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为41.51%、100.00%、70.75%、100.00%和63.10%;肺泡灌洗液G试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为100.00%、73.58%、86.79%、79.10%和100.00%;肺泡灌洗液GM试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为77.36%、64.15%、70.75%、68.33%和73.91%。受试者工作特征(ROC)曲线显示,血清G试验、GM试验和肺泡灌洗液G试验、GM试验检测结果诊断IPFI的曲线下面积(AUC)分别为0.804、0.862、0.978、0.987,均对IPFI有一定鉴别价值。结论:血清和肺泡灌洗液G试验、GM试验检测对IPFI诊断均有一定诊断价值,根据阈值的不同敏感度、特异度互有优劣,临床应结合实际情况参考多种检测结果综合评估。
Objective:To explore the early diagnostic value of(1-3)β-D glucan test(G test)and galactomannantest(GM test)in serum and bronchoalveolar lavage fluid(BALF)for patients with invasive pulmonary fungal infection(IPFI).Methods:A total of 53 patients with IPFI and 53 patients with pulmonary bacterial infectionin the hospital were enrolled as IPFI group and control group,respectively.All patients underwent G test and GM test in serum and bronchoalveolar lavage fluid,and the detection results in the two groups were compared.The diagnostic value of G test and GM test in serum and alveolar lavage fluid was analyzed.Results:The results of serum G test,GM test,alveolar G test and GM test were different between the two groups(P<0.05).Taking results of histopathological examination as the golden standard,sensitivity,specificity,accuracy,positive predictive value and negative predictive value of serum G test,serum GM test,bronchoalveolar lavage fluid G test and bronchoalveolar lavage fluid GM test in the diagnosis of IPFI were(69.81%,100.00%,84.91%,100.00%,76.81%),(41.51%,100.00%,70.75%,100.00%,63.10%),(100.00%,73.58%,86.79%,79.10%,100.00%)and(77.36%,64.15%,70.75%,68.33%,73.91%),respectively.ROC curves analysis showed that area under the curve(AUC)values of serum G test,serum GM test,bronchoalveolar lavage fluid G test and bronchoalveolar lavage fluid GM test in the diagnosis of pulmonary fungal infection were 0.804,0.862,0.978 and 0.987,all of which had certain discriminatory value for IPFI.Conclusion:G test and GM test in serum and bronchoalveolar lavage fluid all have certain diagnostic value for IPFI.According to different thresholds,they have their own advantages and disadvantages in terms of sensitivity and specificity.Clinically,comprehensive assessment should be conducted based on actual situation and multiple detection results.
作者
程家亮
龚国忠
代莉
张孝廉
张俊
CHENG Jia-liang;GONG Guo-zhong;DAI Li;ZHANG Xiao-lian;ZHANG Jun(Department of Laboratory,Suining First People s Hospital,Suining 629000,Sichuan,China)
出处
《川北医学院学报》
2025年第8期1075-1078,共4页
Journal of North Sichuan Medical College
基金
四川省遂宁市院校科技战略合作项目(2021SNXNYD02)。
关键词
血清
肺泡灌洗液
侵袭性肺部真菌感染
诊断价值
Serum
Bronchoalveolar lavage fluid
Invasive pulmonary fungal infection
Diagnostic value
