CAJ | 학술논문

目的评价血清半乳甘露聚糖(GM)检测对血液病患者侵袭性曲霉菌(IA)感染早期诊断的价值.方法前瞻性采用酶联免疫吸附试验(ELISA)每周2次测定患者的GM水平,并计算该诊断试验的各项评价指标.结果共有来自92例患者的113例次感染进入研究,检测血清标本472份,以确诊IA感染和临床诊断IA感染为真阳性组,排除IA感染为真阴性组,0.7为阈值,连续2次GM结果阳性为真阳性,该诊断试验的敏感度为83.3%,特异度为91.1%,阳性预测值为78.9%,阴性预测值为93.1%.GM阳性结果较痰培养阳性时间提前4 d(1～7 d),比影像学改变提早7 d(1～14 d),较抗真菌治疗提前6 d(1～15 d).结论通过ELISA方法进行血清GM检测可以快速、灵敏的为早期诊断IA感染提供有力证据.
목적 평개혈청반유감로취당(GM)검측대혈액병환자침습성곡매균(IA)감염조기진단적개치.방법 전첨성채용매련면역흡부시험(ELISA)매주2차측정환자적GM수평,병계산해진단시험적각항평개지표.결과 공유래자92례환자적113례차감염진입연구,검측혈청표본472빈,이학진IA감염화림상진단IA감염위진양성조,배제IA감염위진음성조,0.7위역치,련속2차GM결과양성위진양성,해진단시험적민감도위83.3%,특이도위91.1%,양성예측치위78.9%,음성예측치위93.1%.GM양성결과교담배양양성시간제전4 d(1～7 d),비영상학개변제조7 d(1～14 d),교항진균치료제전6 d(1～15 d).결론 통과ELISA방법진행혈청GM검측가이쾌속、령민적위조기진단IA감염제공유력증거.
Objective To detect the value of serum galactomannan (GM) for diagnosis of invasive aspergillosis (IA) in hematological patients. Methods We prospectively evaluated the diagnostic value of twice-weekly screening for circulating Aspergillus fumigatus with sanditch enzyme linked immunosorbent assay. Results On the basis of the analysis of 472 serum samples from 113 episodes of 92 patients, the sensitivity, specificity, positive and negative predictive values of the sandwich ELISA for proven and probable IA cases were 83.3 %, 91.1 %, 78.9 % and 93.1 %, respectively, when samples with 2 consecutive positive results≥0.7 were used. Furthermore, GM antigenemia was detected before the onset of radiologic signs with a median of 7 days (range, 1-14 days), before isolation of Aspergillus with a median of 4 days (range, 1-7 days),and before anti-fungal therapy with a median of 6 days (range, 1-15 days). Conclusion The sandwich ELISA for GM detection is a reliable method for early diagnosis of IA in patients with haematological diseases.