临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2015年
7期
1262-1265
,共4页
侵袭性真菌感染%肺泡灌洗液%半乳甘露聚糖
侵襲性真菌感染%肺泡灌洗液%半乳甘露聚糖
침습성진균감염%폐포관세액%반유감로취당
galactomannan%bronchoalveolar lavage%invasive fungal disease
目的：探讨侵袭性真菌感染患者肺泡灌洗液中半乳甘露聚糖( GM )的水平变化及临床意义。方法连续性纳入50例怀疑IFD的恶性血液病患者,25例非IFD的恶性血液病患者作为对照组。检测血清和肺泡灌洗液GM水平,利用ROC曲线分析肺泡灌洗液GM实验对IFD患者的诊断价值。通过单因素和Lo-gistic回归分析计算OR值比较不同临床指标对于GM实验的影响。结果疑似组,拟诊组和确诊组患者肺泡灌洗液GM平均值均高于血清GM平均值(0．31±0．09 ng/ml,0．46±0．12 ng/ml,0．49±0．07 ng/ml vs．0．24±0．08 ng/ml,0．44±0．22 ng/ml,0．48±0．20 ng/ml)。阳性率方面,疑似组,拟诊组和确诊组患者肺泡灌洗液GM阳性率均高于血清GM阳性率(17．5%,33．3%,66．7% vs．3．2%,18．5%,33．3%)。 ROC曲线分析示确诊组患者,确诊组+拟诊组患者以及所有患者AUC分别为0．76,0．69和0．60。抗真菌药物的使用与肺泡灌洗液GM实验阳性率密切相关(P<0．05)。结论在恶性血液病患者中,肺泡灌洗液GM实验有助于对IFD的诊断。
目的：探討侵襲性真菌感染患者肺泡灌洗液中半乳甘露聚糖( GM )的水平變化及臨床意義。方法連續性納入50例懷疑IFD的噁性血液病患者,25例非IFD的噁性血液病患者作為對照組。檢測血清和肺泡灌洗液GM水平,利用ROC麯線分析肺泡灌洗液GM實驗對IFD患者的診斷價值。通過單因素和Lo-gistic迴歸分析計算OR值比較不同臨床指標對于GM實驗的影響。結果疑似組,擬診組和確診組患者肺泡灌洗液GM平均值均高于血清GM平均值(0．31±0．09 ng/ml,0．46±0．12 ng/ml,0．49±0．07 ng/ml vs．0．24±0．08 ng/ml,0．44±0．22 ng/ml,0．48±0．20 ng/ml)。暘性率方麵,疑似組,擬診組和確診組患者肺泡灌洗液GM暘性率均高于血清GM暘性率(17．5%,33．3%,66．7% vs．3．2%,18．5%,33．3%)。 ROC麯線分析示確診組患者,確診組+擬診組患者以及所有患者AUC分彆為0．76,0．69和0．60。抗真菌藥物的使用與肺泡灌洗液GM實驗暘性率密切相關(P<0．05)。結論在噁性血液病患者中,肺泡灌洗液GM實驗有助于對IFD的診斷。
목적：탐토침습성진균감염환자폐포관세액중반유감로취당( GM )적수평변화급림상의의。방법련속성납입50례부의IFD적악성혈액병환자,25례비IFD적악성혈액병환자작위대조조。검측혈청화폐포관세액GM수평,이용ROC곡선분석폐포관세액GM실험대IFD환자적진단개치。통과단인소화Lo-gistic회귀분석계산OR치비교불동림상지표대우GM실험적영향。결과의사조,의진조화학진조환자폐포관세액GM평균치균고우혈청GM평균치(0．31±0．09 ng/ml,0．46±0．12 ng/ml,0．49±0．07 ng/ml vs．0．24±0．08 ng/ml,0．44±0．22 ng/ml,0．48±0．20 ng/ml)。양성솔방면,의사조,의진조화학진조환자폐포관세액GM양성솔균고우혈청GM양성솔(17．5%,33．3%,66．7% vs．3．2%,18．5%,33．3%)。 ROC곡선분석시학진조환자,학진조+의진조환자이급소유환자AUC분별위0．76,0．69화0．60。항진균약물적사용여폐포관세액GM실험양성솔밀절상관(P<0．05)。결론재악성혈액병환자중,폐포관세액GM실험유조우대IFD적진단。
Objective To evaluate the diagnostic value of galactomannan in bronchoalveolar lavage ( BAL) for invasive fungal disease ( IFD) . Methods 50 hematological malignancies patients with suspected IFD and 25 he-matological malignancies patients with non-IFD were enrolled in this study. The levels of GM were measured in BAL and serum by ELISA. ROC curve analysis was used to evaluate the diagnosis value. Univariate and multivariable lo-gistic regression analysis was performed with BAL GM. Results The levels of GM in BAL were higher than those in serum in the proven group, the possible group and the probable group (0. 31 ± 0. 09ng/ml, 0. 46 ± 0. 12ng/ml, 0. 49 ± 0. 07 ng/ml vs. 0. 24 ± 0. 08ng/ml, 0. 44 ± 0. 22ng/ml, 0. 48 ± 0. 20 ng/ml). The GM positive rate in BAL were higher than those in serum ( 17. 5%, 33. 3%, 66. 7% vs. 3. 2%, 18. 5%, 33. 3%) . The AUC in the proven group, the proven+probable group and the proven+probable+possible group were 0. 76, 0. 69 and 0. 60 respective-ly. It showed a significant relation between the usage of anti-fungal treatment and GM positive in BAL. Conclusion GM in BAL may be a promising marker for diagnosing IFD in immunocompromised patients.
