中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2008年
4期
287-290
,共4页
文昱婷%赵蓓蕾%吕沛华%施毅
文昱婷%趙蓓蕾%呂沛華%施毅
문욱정%조배뢰%려패화%시의
真菌病%诊断%半乳甘露聚糖
真菌病%診斷%半乳甘露聚糖
진균병%진단%반유감로취당
Mycoses%Diagnosis%Galactomannan
目的 评价血清半乳甘露聚糖(GM)检测对侵袭性曲霉病(IA)的诊断价值.方法 南京军区南京总医院2005年1月至2007年2月确诊的侵袭性真菌感染(IFI)住院患者49例,平均年龄55岁,男34例,女15例,其中IA 11例,其他IFI 20例,曲霉气道定植18例.采用Platelia Aspergillus(法国Bio-Rad公司)双夹心ELISA检测试剂盒检测患者的血清GM吸光度指数(简称GM值),IA患者中6例于治疗后7 d重复检测.正态分布计量资料以-x±s表示,多组间比较采用单因素方差分析,治疗前后比较采用配对t检验,采用SPSS统计软件处理实验数据.结果 IA患者血清GM值为1.63±0.29,其他IFI和曲霉气道定植患者分别为0.96±0.49和0.83±0.43,IA患者与后两者比较差异有统计学意义(F=12.681,P＜0.05).6例IA患者治疗前后GM值分别为1.67±0.24和1.62±0.28(t=0.475,P＞0.05).以GM值为1.5作为诊断阈值诊断IA的敏感度、特异度、阳性预测值和阴性预测值分别为72.7%、84.2%、57.1%和94.1%.结论 血清GM检测对IA具有诊断价值,可区分IA与其他IFI和曲霉气道定植;以GM值为1.5作为诊断阈值诊断IA的敏感度、特异度较理想.
目的 評價血清半乳甘露聚糖(GM)檢測對侵襲性麯黴病(IA)的診斷價值.方法 南京軍區南京總醫院2005年1月至2007年2月確診的侵襲性真菌感染(IFI)住院患者49例,平均年齡55歲,男34例,女15例,其中IA 11例,其他IFI 20例,麯黴氣道定植18例.採用Platelia Aspergillus(法國Bio-Rad公司)雙夾心ELISA檢測試劑盒檢測患者的血清GM吸光度指數(簡稱GM值),IA患者中6例于治療後7 d重複檢測.正態分佈計量資料以-x±s錶示,多組間比較採用單因素方差分析,治療前後比較採用配對t檢驗,採用SPSS統計軟件處理實驗數據.結果 IA患者血清GM值為1.63±0.29,其他IFI和麯黴氣道定植患者分彆為0.96±0.49和0.83±0.43,IA患者與後兩者比較差異有統計學意義(F=12.681,P＜0.05).6例IA患者治療前後GM值分彆為1.67±0.24和1.62±0.28(t=0.475,P＞0.05).以GM值為1.5作為診斷閾值診斷IA的敏感度、特異度、暘性預測值和陰性預測值分彆為72.7%、84.2%、57.1%和94.1%.結論 血清GM檢測對IA具有診斷價值,可區分IA與其他IFI和麯黴氣道定植;以GM值為1.5作為診斷閾值診斷IA的敏感度、特異度較理想.
목적 평개혈청반유감로취당(GM)검측대침습성곡매병(IA)적진단개치.방법 남경군구남경총의원2005년1월지2007년2월학진적침습성진균감염(IFI)주원환자49례,평균년령55세,남34례,녀15례,기중IA 11례,기타IFI 20례,곡매기도정식18례.채용Platelia Aspergillus(법국Bio-Rad공사)쌍협심ELISA검측시제합검측환자적혈청GM흡광도지수(간칭GM치),IA환자중6례우치료후7 d중복검측.정태분포계량자료이-x±s표시,다조간비교채용단인소방차분석,치료전후비교채용배대t검험,채용SPSS통계연건처리실험수거.결과 IA환자혈청GM치위1.63±0.29,기타IFI화곡매기도정식환자분별위0.96±0.49화0.83±0.43,IA환자여후량자비교차이유통계학의의(F=12.681,P＜0.05).6례IA환자치료전후GM치분별위1.67±0.24화1.62±0.28(t=0.475,P＞0.05).이GM치위1.5작위진단역치진단IA적민감도、특이도、양성예측치화음성예측치분별위72.7%、84.2%、57.1%화94.1%.결론 혈청GM검측대IA구유진단개치,가구분IA여기타IFI화곡매기도정식;이GM치위1.5작위진단역치진단IA적민감도、특이도교이상.
Objective To assess the value of Aspergillus galactomannan(GM)double-direct sandwich enzyme-linked immunosorbent assay(ELISA)in the diagnosis of invasive aspergillosis(IA).Methods Forty nine patients were divided into IA group(n=11),other invasive fungal infection group (n=20)and Aspergillus colonization group(n=18).The serum samples of all patients and 6 patients with IA after 7 day treatment were used for GM detection.A double-direct sandwich ELISA was employed to detect GM optical density index(ODI)in the serum samples.Measurement data followed the Gaussian distribution were expressed as-x±s.Differences among groups were tested using a one factor analysis of variance.The significance of variation before and after therapy was tested with paired t test.P＜0.05 were considered to represent a significant difference.Statistical analyses were performed by SPSS statistical package.Results The serum GM ODI in IA patients was higher(1.63±0.29)than that in other IFI patients(0.96±0.49)and Aspergillus colonization patients(0.83±0.43),F=12.681,P＜0.05.The serum GM ODI of 6 patients with IA before and after treatment were 1.67±0.24 and 1.62±0.28(t=0.475,P＞0.05),respectively.If the cutoff GM ODI was 1.5,the sensitivity,specificity,positive predictive value and negative predictive value for diagnosis of IA in the patients were 72.7%,84.2%,57.1%and 94.1%,respectively.Conclusions The serum GM detection has diagnostic value for IA and could distinguish Aspergillus infection from other invasive fungal infections and Aspergillus colonization.A cutoff GM ODI of 1.5 showed the best sensitivity and specificity for IA in the patients.
