CAJ | 학술논문

目的：探讨血清（1，3）-β-D-葡聚糖含量检测（G试验）和半乳甘露聚糖含量检测（GM试验）对儿童血液病患者侵袭性真菌感染（ IFI）的诊断价值。方法选择儿童血液病患儿246例，根据是否诊断IFI分为感染组27例和非感染组219例。采用动态试管比浊法和酶联免疫吸附法检测患者血清（1，3）-β-D-葡聚糖含量和半乳甘露聚糖含量。计算G试验、GM试验单独和联合应用诊断IFI的敏感性、特异性、阳性预测值和阴性预测值。结果 G试验诊断儿童血液病 IFI 的敏感性、特异性、阳性预测值和阴性预测值分别是88．89％、91．78％、57．14％和98．53％；GM试验分别是66．67％、71．23％、22．22％和94．55％；G试验、GM 试验并联分别是100％、65．75％、26．47％和100％；G试验、GM试验串联分别是55．56％、97．26％、71．43％和94．67％。 G试验、GM试验串联诊断IFI特异性和阳性预测值与其他试验比较有统计学差异（P均＜0．05）。结论 G试验、GM试验对儿童血液病患者IFI具有一定的诊断价值，G试验和GM试验串联分析对IFI的诊断价值更高。
목적：탐토혈청（1，3）-β-D-포취당함량검측（G시험）화반유감로취당함량검측（GM시험）대인동혈액병환자침습성진균감염（ IFI）적진단개치。방법선택인동혈액병환인246례，근거시부진단IFI분위감염조27례화비감염조219례。채용동태시관비탁법화매련면역흡부법검측환자혈청（1，3）-β-D-포취당함량화반유감로취당함량。계산G시험、GM시험단독화연합응용진단IFI적민감성、특이성、양성예측치화음성예측치。결과 G시험진단인동혈액병 IFI 적민감성、특이성、양성예측치화음성예측치분별시88．89％、91．78％、57．14％화98．53％；GM시험분별시66．67％、71．23％、22．22％화94．55％；G시험、GM 시험병련분별시100％、65．75％、26．47％화100％；G시험、GM시험천련분별시55．56％、97．26％、71．43％화94．67％。 G시험、GM시험천련진단IFI특이성화양성예측치여기타시험비교유통계학차이（P균＜0．05）。결론 G시험、GM시험대인동혈액병환자IFI구유일정적진단개치，G시험화GM시험천련분석대IFI적진단개치경고。
Objective To evaluate the diagnostic value of serum (1, 3) -β-D-glucan (G assay) and galactomannan (GM assay) for invasive fungal infections in pediatric patients with hematological malignancies .Methods Totally 246 pe-diatric patients with hematological malignancies were selected to our study .According to invasive fungal infections diagnos-tic criteria, they were divided into two groups:infection group (n=27), non-infected group(n=219).The concentration of serum (1, 3) -β-D-glucan and galactomannan was detected by kinetic turbidimetric limulus test and ELISA .The sensi-tivity, specificity, positive predictive value and negative predictive value of GM test and G test and the combination of GM and G tests were calculated in diagnosing IFI .Results The sensitivity, specificity, positive predictive value and negative predictive values of G assay for the diagnosis of pediatric patients with invasive fungal infections were 88.89%, 91.78%, 57.14%and 98.53%, respectively; GM assay results were 66.67%, 71.23%, 22.22% and 94.55%, respectively;The results of G assay with GM assay using parallel analysis were 100%, 65.75%, 26.47%%and 100%, respectively;Using series analysis were 55.56%, 97.26%, 71.43%and 94.67%, respectively.Conclusions The G assay and GM assay were both useful in diagnosis of invasive fungal infections in pediatric patients with hematological malignancies .Using series analysis of G assay and GM assay can improve diagnostic specificity and positive predictive value .