中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
32期
2268-2270
,共3页
胡华%杨燕%滕隔玲%鞠云飞%张琳琳%魏敏
鬍華%楊燕%滕隔玲%鞠雲飛%張琳琳%魏敏
호화%양연%등격령%국운비%장림림%위민
半乳甘露聚糖%支气管肺泡灌洗液%肺曲霉病%诊断
半乳甘露聚糖%支氣管肺泡灌洗液%肺麯黴病%診斷
반유감로취당%지기관폐포관세액%폐곡매병%진단
Galactomannan%Bronchoalveolar lavage fluid%Pulmonary aspergillosis%Diagnosis
目的 探讨支气管肺泡灌洗液(BALF)中半乳甘露聚糖抗原(GM)检测在肺曲霉病诊断中的价值.方法 将2008年8月至2012年4月山东省胸科医院呼吸科住院疑似肺曲霉感染121例患者,依据2008年欧洲癌症研究治疗组织/国立研究院(EORTC/MSG)真菌病研究小组制定的诊断标准及分级分为肺曲霉病组(57例)和非肺曲霉病组(64例),采用ELISA方法检测患者血清及BALF中GM抗原的吸光度(A)值及I值,并进行比较分析.结果 肺曲霉病组经病理确诊20例、临床确诊37例,其血清及BALF中GM的I值平均秩次为88.21、86.49,较非肺曲霉病组(36.77、38.30)均明显升高(均P＜0.01).血清GM检测的I值=0.5、0.8、1.0时,灵敏度为0.842、0.649、0.228,特异度为0.906、0.938、0.929,阳性预测值为0.889、0.902、0.984,阴性预测值为0.866、0.750、0.589,最佳临界值0.550.BALF中GM检测的I值=0.5、0.8、1.0时,灵敏度为0.930、0.657、0.561,特异度为0.766、0.922、0.969,阳性预测值为0.779、0.884、0.941,阴性预测值为0.925、0.756、0.713；最佳临界值为0.720.结论 BALF中GM的检测可用于临床肺曲霉病的辅助诊断.
目的 探討支氣管肺泡灌洗液(BALF)中半乳甘露聚糖抗原(GM)檢測在肺麯黴病診斷中的價值.方法 將2008年8月至2012年4月山東省胸科醫院呼吸科住院疑似肺麯黴感染121例患者,依據2008年歐洲癌癥研究治療組織/國立研究院(EORTC/MSG)真菌病研究小組製定的診斷標準及分級分為肺麯黴病組(57例)和非肺麯黴病組(64例),採用ELISA方法檢測患者血清及BALF中GM抗原的吸光度(A)值及I值,併進行比較分析.結果 肺麯黴病組經病理確診20例、臨床確診37例,其血清及BALF中GM的I值平均秩次為88.21、86.49,較非肺麯黴病組(36.77、38.30)均明顯升高(均P＜0.01).血清GM檢測的I值=0.5、0.8、1.0時,靈敏度為0.842、0.649、0.228,特異度為0.906、0.938、0.929,暘性預測值為0.889、0.902、0.984,陰性預測值為0.866、0.750、0.589,最佳臨界值0.550.BALF中GM檢測的I值=0.5、0.8、1.0時,靈敏度為0.930、0.657、0.561,特異度為0.766、0.922、0.969,暘性預測值為0.779、0.884、0.941,陰性預測值為0.925、0.756、0.713；最佳臨界值為0.720.結論 BALF中GM的檢測可用于臨床肺麯黴病的輔助診斷.
목적 탐토지기관폐포관세액(BALF)중반유감로취당항원(GM)검측재폐곡매병진단중적개치.방법 장2008년8월지2012년4월산동성흉과의원호흡과주원의사폐곡매감염121례환자,의거2008년구주암증연구치료조직/국립연구원(EORTC/MSG)진균병연구소조제정적진단표준급분급분위폐곡매병조(57례)화비폐곡매병조(64례),채용ELISA방법검측환자혈청급BALF중GM항원적흡광도(A)치급I치,병진행비교분석.결과 폐곡매병조경병리학진20례、림상학진37례,기혈청급BALF중GM적I치평균질차위88.21、86.49,교비폐곡매병조(36.77、38.30)균명현승고(균P＜0.01).혈청GM검측적I치=0.5、0.8、1.0시,령민도위0.842、0.649、0.228,특이도위0.906、0.938、0.929,양성예측치위0.889、0.902、0.984,음성예측치위0.866、0.750、0.589,최가림계치0.550.BALF중GM검측적I치=0.5、0.8、1.0시,령민도위0.930、0.657、0.561,특이도위0.766、0.922、0.969,양성예측치위0.779、0.884、0.941,음성예측치위0.925、0.756、0.713；최가림계치위0.720.결론 BALF중GM적검측가용우림상폐곡매병적보조진단.
Objective To prospectively evaluate the utility of detecting bronchoalveolar lavage fluid (BALF) Aspergillus galactomannan antigen (GM) in the diagnosis of pulmonary aspergillosis.Methods From August 2008 to April 2012,121 patients suspected of pulmonary aspergillosis were recruited and classified into pulmonary aspergillosis group (n =57) and non-pulmonary disease group (n =64) according to the 2008 diagnostic criteria and classification of European Organization for Research and Treatment of Cancer / National Institute of Mycoses Study Group (EORTC/MSG).The absorbency (A) and I value of GM in the patients' serum and BALF were detected by enzyme-linked immunosorbent assay (ELISA).And their values were compared and analyzed. Results Twenty cases were confirmed by pathological examinations and 37 cases by clinical diagnosis in the pulmonary aspergillosis group.The mean rank of GM's I value in the serum and BALF samples was 88.21 and 86.49.And they significantly increased compared with the non-pulmonary aspergillosis group (36.77,38.30) (P ＜0.01 ).At a different serum GM threshold I =0.5,0.8,1.0,the sensitivities were 0.842,0.649 and 0.228 ; the specificities 0.906,0.938,0.929 ;the positive predictive values 0.889,0.902,0.984 and the negative predictive values 0.866,0.750,0.589 respectively.And at a different BALF GM threshold I =0.5,0.8,1.0,the sensitivities were 0.930,0.657,0.561 ; the specificities 0.766,0.922,0.969 ; the positive predictive values 0.779,0.884,0.941and the negative predictive values 0.925,0.756,0.713 respectively.Conclusion The detection of GM in BALF may be employed for the clinical diagnosis of pulmonary aspergillosis.
