全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2015年
3期
252-254
,共3页
支气管肺泡灌洗液%半乳甘露聚糖%侵袭性肺曲霉感染
支氣管肺泡灌洗液%半乳甘露聚糖%侵襲性肺麯黴感染
지기관폐포관세액%반유감로취당%침습성폐곡매감염
bronchoalveolar lavage fluid%galactomannan%invasive pulmonary aspergillosis
目的：探究血清及支气管肺泡灌洗液（BALF）中半乳甘露聚糖（GM）水平对侵袭性肺曲霉感染（IPA）的诊疗价值。方法选择疑似IPA的96例肺部疾病患者作为研究对象，确诊IPA的有4例，临床诊断IPA的有16例，拟诊IPA的有10例，共有30例患者纳入观察组。诊断非IPA的66例为对照组。采用单克隆体双层夹心酶联免疫吸附测定（ELISA）检测方法进行血清和BALF的GM检测；并比较两种GM检测方法的诊断效率。结果观察组中的BALF GM 值和血清GM值均明显高于对照组，差异均有统计学意义（t分别=5.76、3.79，P均＜0.05）；而在观察组中的BALF GM值高于同组的血清GM值，差异有统计学意义（t=4.46，P＜0.05）。当界定GM值≥0.5时，BALF GM检测的灵敏度、阳性预测值和阴性预测值都高于血清GM检测，仅特异度略低于血清GM检测。而当界定GM值≥1.0时，BALF GM检测的灵敏度、阴性预测值、特异度和阳性预测值都高于血清GM检测。结论在IPA的诊断中，BALF的GM 检测比血清 GM检测具有更好的效果，更有利于早期诊断和治疗。
目的：探究血清及支氣管肺泡灌洗液（BALF）中半乳甘露聚糖（GM）水平對侵襲性肺麯黴感染（IPA）的診療價值。方法選擇疑似IPA的96例肺部疾病患者作為研究對象，確診IPA的有4例，臨床診斷IPA的有16例，擬診IPA的有10例，共有30例患者納入觀察組。診斷非IPA的66例為對照組。採用單剋隆體雙層夾心酶聯免疫吸附測定（ELISA）檢測方法進行血清和BALF的GM檢測；併比較兩種GM檢測方法的診斷效率。結果觀察組中的BALF GM 值和血清GM值均明顯高于對照組，差異均有統計學意義（t分彆=5.76、3.79，P均＜0.05）；而在觀察組中的BALF GM值高于同組的血清GM值，差異有統計學意義（t=4.46，P＜0.05）。噹界定GM值≥0.5時，BALF GM檢測的靈敏度、暘性預測值和陰性預測值都高于血清GM檢測，僅特異度略低于血清GM檢測。而噹界定GM值≥1.0時，BALF GM檢測的靈敏度、陰性預測值、特異度和暘性預測值都高于血清GM檢測。結論在IPA的診斷中，BALF的GM 檢測比血清 GM檢測具有更好的效果，更有利于早期診斷和治療。
목적：탐구혈청급지기관폐포관세액（BALF）중반유감로취당（GM）수평대침습성폐곡매감염（IPA）적진료개치。방법선택의사IPA적96례폐부질병환자작위연구대상，학진IPA적유4례，림상진단IPA적유16례，의진IPA적유10례，공유30례환자납입관찰조。진단비IPA적66례위대조조。채용단극륭체쌍층협심매련면역흡부측정（ELISA）검측방법진행혈청화BALF적GM검측；병비교량충GM검측방법적진단효솔。결과관찰조중적BALF GM 치화혈청GM치균명현고우대조조，차이균유통계학의의（t분별=5.76、3.79，P균＜0.05）；이재관찰조중적BALF GM치고우동조적혈청GM치，차이유통계학의의（t=4.46，P＜0.05）。당계정GM치≥0.5시，BALF GM검측적령민도、양성예측치화음성예측치도고우혈청GM검측，부특이도략저우혈청GM검측。이당계정GM치≥1.0시，BALF GM검측적령민도、음성예측치、특이도화양성예측치도고우혈청GM검측。결론재IPA적진단중，BALF적GM 검측비혈청 GM검측구유경호적효과，경유리우조기진단화치료。
Objective To study the diagnostic value of detecting galactomannan (GM) in serum and bronchoalveolar lavage fluid (BALF) among the patients with invasive pulmonary aspergillosis(IPA). Methods A total of 96 cases of sus-pected IPA with lung disease were selected as research subjects. There were 3 cases of definite diagnosis of IPA, 16 cases of clinical diagnosis of IPA and 10 cases of suspected IPA that included in the observation group and 66 cases of non-IPA as the control group. The GM in serum and BALF were detected by ELISA, and the diagnostic efficiencies of two GM test-ing were analyzed. Results The GM in BALF and serum of the observation group were significantly higher than the control group (t=5.76,3.79,P<0.05). The GM in BALF of observation group was significantly higher than the GM in serum (t=4.46,P<0.05). When the cut-off of GM was equal or greater than 0.5, the sensitivity, positive predictive value and nega-tive predictive value of GM in BALF were significantly higher than GM in serum while the specificity was lower than GM in serum. When the cut-off of GM was equal or greater than 1.0, the sensitivity, negative predictive value, specificity and positive predictive values of GM in BALF were significantly higher than GM in serum. Conclusion In the diagnosis of I-PA, diagnostic efficiencies of GM in BALF is better than GM in serum.
