中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
1期
78-81
,共4页
陈理达%黄杰凤%林其昌%陈公平%陈晓%吴李花%谢汉生
陳理達%黃傑鳳%林其昌%陳公平%陳曉%吳李花%謝漢生
진리체%황걸봉%림기창%진공평%진효%오리화%사한생
曲霉菌病%甘露聚糖类%β内酰胺类
麯黴菌病%甘露聚糖類%β內酰胺類
곡매균병%감로취당류%β내선알류
Aspergillosis%Mannans%Beta-lactams
目的 探讨不同种类β内酰胺类抗生素对肺部疾病患者血清半乳甘露聚糖检测假阳性率的影响. 方法 选择因肺部疾病而入住呼吸内科并接受不同β内酰胺类抗生素治疗的非侵袭性曲霉菌病(IPA)患者77例作为试验组,以41例未使用任何抗生素的非IPA患者为对照组,两组均行血清半乳甘露聚糖检测,比较两组半乳甘露聚糖的假阳性率. 结果 哌拉西林/他唑巴坦组患者半乳甘露聚糖的假阳性率为30.8％(8/26),头孢哌酮/舒巴坦组患者假阳性率为27.8％(5/18).使用β内酰胺类抗生素组发生半乳甘露聚糖假阳性率显著高于对照组[24.7％(19/77)比7.3％(3/41),x2=5.315,P=0.025].以半乳甘露聚糖假阳性为因变量,是否应用β内酰胺类抗生素为自变量行单因素Logistic回归分析,结果显示,应用β内酰胺类抗生素组发生半乳甘露聚糖假阳性率的几率是对照组的4.149倍(OR=4.149,P=0.030). 结论 使用β内酰胺类抗生素可能增加血清半乳甘露聚糖检测假阳性率,临床医生在解读血清半乳甘露聚糖检测结果时需注意排除抗生素的影响.
目的 探討不同種類β內酰胺類抗生素對肺部疾病患者血清半乳甘露聚糖檢測假暘性率的影響. 方法 選擇因肺部疾病而入住呼吸內科併接受不同β內酰胺類抗生素治療的非侵襲性麯黴菌病(IPA)患者77例作為試驗組,以41例未使用任何抗生素的非IPA患者為對照組,兩組均行血清半乳甘露聚糖檢測,比較兩組半乳甘露聚糖的假暘性率. 結果 哌拉西林/他唑巴坦組患者半乳甘露聚糖的假暘性率為30.8％(8/26),頭孢哌酮/舒巴坦組患者假暘性率為27.8％(5/18).使用β內酰胺類抗生素組髮生半乳甘露聚糖假暘性率顯著高于對照組[24.7％(19/77)比7.3％(3/41),x2=5.315,P=0.025].以半乳甘露聚糖假暘性為因變量,是否應用β內酰胺類抗生素為自變量行單因素Logistic迴歸分析,結果顯示,應用β內酰胺類抗生素組髮生半乳甘露聚糖假暘性率的幾率是對照組的4.149倍(OR=4.149,P=0.030). 結論 使用β內酰胺類抗生素可能增加血清半乳甘露聚糖檢測假暘性率,臨床醫生在解讀血清半乳甘露聚糖檢測結果時需註意排除抗生素的影響.
목적 탐토불동충류β내선알류항생소대폐부질병환자혈청반유감로취당검측가양성솔적영향. 방법 선택인폐부질병이입주호흡내과병접수불동β내선알류항생소치료적비침습성곡매균병(IPA)환자77례작위시험조,이41례미사용임하항생소적비IPA환자위대조조,량조균행혈청반유감로취당검측,비교량조반유감로취당적가양성솔. 결과 고랍서림/타서파탄조환자반유감로취당적가양성솔위30.8％(8/26),두포고동/서파탄조환자가양성솔위27.8％(5/18).사용β내선알류항생소조발생반유감로취당가양성솔현저고우대조조[24.7％(19/77)비7.3％(3/41),x2=5.315,P=0.025].이반유감로취당가양성위인변량,시부응용β내선알류항생소위자변량행단인소Logistic회귀분석,결과현시,응용β내선알류항생소조발생반유감로취당가양성솔적궤솔시대조조적4.149배(OR=4.149,P=0.030). 결론 사용β내선알류항생소가능증가혈청반유감로취당검측가양성솔,림상의생재해독혈청반유감로취당검측결과시수주의배제항생소적영향.
Objective To investigate the effect of β-lactam antibiotics on the false positive rate of the serum Aspergillus galactomannan (GM) assay in patients with lung diseases.Methods We selectively recruited 77 lung disease patients who did not meet the diagnostic criteria of invasive pulmonary Aspergillosis (IPA) and received different β-lactam antibiotics,while 41 patients without IPA who did not receive any antibiotic treatment were recruited as the control group.Serum samples for GM detection were collected from all participants.The rate of false-positive Aspergillus galactomannan was compared between the two groups.Results False-positive serum results were found in patients who received piperacillin-tazobactam (30.8％ or 8/26) and cefoperazone sulbactamand (27.8％ or 5/18).The rate of false-positive Aspergillus galactomannan in patients who receive β-lactam antibiotics were significantly higher than that in the control group (24.7％ or 19/77vs.7.3％ or 3/41,x2 =5.315,P=0.025).Taking false-positive serum Aspergillus galactomannan as the dependent variable and β-lactam antibiotic treatment as the independent variable,univariate logistic regression analysis showed that the rate of false-positive Aspergillus galactomannan in patients who received β-lactam antibiotics were 4.149 times more than that in the control group (OR=4.149,P=0.030).Conclusions The administration of β-lactam antibiotics may increase the occurrence of false-positive serum Aspergillus galactomannan,and physicians should be aware of this possible interference.
