国际检验医学杂志
國際檢驗醫學雜誌
국제검험의학잡지
INTERNATIONAL JOURNAL OF LABORATORY MEDICINE
2014年
16期
2185-2186,2193
,共3页
殷潇娴%王玉月%张淑瑛%史伟峰
慇瀟嫻%王玉月%張淑瑛%史偉峰
은소한%왕옥월%장숙영%사위봉
血浆(1,3)-β-D葡聚糖%侵袭性真菌感染%G试验
血漿(1,3)-β-D葡聚糖%侵襲性真菌感染%G試驗
혈장(1,3)-β-D포취당%침습성진균감염%G시험
plasma(1,3)-β-D-glucan%invasive fungal infection%G test
目的：探讨血浆（1，3）-β-D 葡聚糖检测（G 试验）对侵袭性真菌感染（IFI）的临床诊断价值。方法2013年1～9月收集 IFI 组67例、非 IFI 组61例及健康对照组48例血浆标本，应用动态浊度法检测血浆（1，3）-β-D 葡聚糖水平，通过受试者工作特征曲线（ROC）确定 G 试验最佳临界值。结果 IFI 组、非 IFI 组及健康对照组血浆（1，3）-β-D 葡聚糖水平皆为非正态分布。IFI 组的血浆（1，3）-β-D 葡聚糖水平中位数208．00 pg/mL 明显高于非 IFI 组61．30 pg/mL（Z ＝-5．083，P ＜0．01）和健康对照组31．16 pg/mL（Z＝-8．288，P ＜0．01）。G 试验用于诊断 IFI 的 ROC 曲线下面积为0．846，最佳临界值为90．49 pg/mL，其对应的灵敏度、特异性、阳性预测值和阴性预测值分别为86．6％、77．1％、69．9％和90．3％；同时，真菌培养诊断 IFI 的灵敏度、特异性、阳性预测值和阴性预测值分别为53．7％、94．5％、85．7％和61．9％。结论血浆（1，3）-β-D 葡聚糖检测灵敏度高，阴性预测值好，但有时发生假阳性，建议临床在诊断 IFI 时，动态检测 G 试验并联合真菌培养以提高 IFI 的诊断效率。
目的：探討血漿（1，3）-β-D 葡聚糖檢測（G 試驗）對侵襲性真菌感染（IFI）的臨床診斷價值。方法2013年1～9月收集 IFI 組67例、非 IFI 組61例及健康對照組48例血漿標本，應用動態濁度法檢測血漿（1，3）-β-D 葡聚糖水平，通過受試者工作特徵麯線（ROC）確定 G 試驗最佳臨界值。結果 IFI 組、非 IFI 組及健康對照組血漿（1，3）-β-D 葡聚糖水平皆為非正態分佈。IFI 組的血漿（1，3）-β-D 葡聚糖水平中位數208．00 pg/mL 明顯高于非 IFI 組61．30 pg/mL（Z ＝-5．083，P ＜0．01）和健康對照組31．16 pg/mL（Z＝-8．288，P ＜0．01）。G 試驗用于診斷 IFI 的 ROC 麯線下麵積為0．846，最佳臨界值為90．49 pg/mL，其對應的靈敏度、特異性、暘性預測值和陰性預測值分彆為86．6％、77．1％、69．9％和90．3％；同時，真菌培養診斷 IFI 的靈敏度、特異性、暘性預測值和陰性預測值分彆為53．7％、94．5％、85．7％和61．9％。結論血漿（1，3）-β-D 葡聚糖檢測靈敏度高，陰性預測值好，但有時髮生假暘性，建議臨床在診斷 IFI 時，動態檢測 G 試驗併聯閤真菌培養以提高 IFI 的診斷效率。
목적：탐토혈장（1，3）-β-D 포취당검측（G 시험）대침습성진균감염（IFI）적림상진단개치。방법2013년1～9월수집 IFI 조67례、비 IFI 조61례급건강대조조48례혈장표본，응용동태탁도법검측혈장（1，3）-β-D 포취당수평，통과수시자공작특정곡선（ROC）학정 G 시험최가림계치。결과 IFI 조、비 IFI 조급건강대조조혈장（1，3）-β-D 포취당수평개위비정태분포。IFI 조적혈장（1，3）-β-D 포취당수평중위수208．00 pg/mL 명현고우비 IFI 조61．30 pg/mL（Z ＝-5．083，P ＜0．01）화건강대조조31．16 pg/mL（Z＝-8．288，P ＜0．01）。G 시험용우진단 IFI 적 ROC 곡선하면적위0．846，최가림계치위90．49 pg/mL，기대응적령민도、특이성、양성예측치화음성예측치분별위86．6％、77．1％、69．9％화90．3％；동시，진균배양진단 IFI 적령민도、특이성、양성예측치화음성예측치분별위53．7％、94．5％、85．7％화61．9％。결론혈장（1，3）-β-D 포취당검측령민도고，음성예측치호，단유시발생가양성，건의림상재진단 IFI 시，동태검측 G 시험병연합진균배양이제고 IFI 적진단효솔。
Objective To explore the clinical value of plasma(1,3)-β-D-glucan detection(G test)in the diagnosis of invasive fun-gal infections(IFI).Methods The plasma samples were collected in 67 cases of IFI,61 cases of non-IFI and 48 healthy controls from January to September 2013.The level of(1,3)-D-glucan in plasma was detected by the kinetic turbidimetric assay and the opti-mal critical value of the G test was determined by receiver operating characteristic curve(ROC).Results The levels of(1,3)-β-D glucan in the IFI,non-IFI and healthy control groups showed the non-normal distribution.However,the median level of plasma(1, 3)-β-D glucan in the IFI group was 208.00pg/mL,which was significantly higher than 61.30 pg/mL(Z =-5.083,P <0.01)in the non-IFI group and 31.16 pg/mL(Z =-8.288,P <0.01)in the healthy control group.The area under ROC of the G test for diag-nosing IFI was 0.846 and the optimal critical value was 90.49pg/mL.The corresponding sensitivity,specificity,positive and nega-tive predictive values were 86.6%,77.1%,69.9% and 90.3%,respectively;at the same time,which of the fungal culture for diag-nosing IFI were 53.7%,94.5%,85.7% and 61.9% respectively.Conclusion Plasma(1,3)-β-D-glucan detection exhibits the high sensitivity and the better negative predictive value for the diagnosis of IFI.But the false positive results occur at times.It is sugges-ted that the G test can be dynamically conducted combined with the fungal culture for improving the efficiency of IFI diagnosis.
