CAJ | 학술논문

目的：探讨应用血浆1，3‐β‐D葡聚糖（BG ）用于诊断卡氏肺孢子菌肺炎的临床价值。方法选取确诊卡氏肺孢子菌肺炎（PC P ）的患者50例，卡氏肺孢子菌（PC ）定植的患者50例及同期非 PC定植的患者50例，检测其血浆中的BG浓度。结果 PCP患者血浆BG的中位数是698．5 pg／mL [四分位距（IQR）：184．4～1256．0 pg／mL]，高于PC定植患者和非PC定植患者的血浆BG中位数66．5pg／mL（IQR：50．0～91．0 pg／mL）、135．9 pg／mL （IQR：54．0～556．3 pg／mL ）。 PCP 患者血浆 BG 的平均水平是（1022．8±982．6）pg／mL ，明显高于 PC 定植[（74．7±33．6）pg／mL]和非PC定植[（562．7±934．9）pg／mL]患者血浆BG的平均水平，差异有统计学意义（P＜0．05）。以151．5 pg／mL为阳性临界值时，血浆BG诊断PCP的敏感性、特异性、阳性预测值和阴性预测值分别是96．0％、74．0％、64．9％和97．4％。以血浆BG作为PCP的诊断方法时，AUC为0．89。结论血浆BG可以作为PCP的一个早期诊断指标，同时可以根据BG结果鉴别PCP或PC定植。
목적：탐토응용혈장1，3‐β‐D포취당（BG ）용우진단잡씨폐포자균폐염적림상개치。방법선취학진잡씨폐포자균폐염（PC P ）적환자50례，잡씨폐포자균（PC ）정식적환자50례급동기비 PC정식적환자50례，검측기혈장중적BG농도。결과 PCP환자혈장BG적중위수시698．5 pg／mL [사분위거（IQR）：184．4～1256．0 pg／mL]，고우PC정식환자화비PC정식환자적혈장BG중위수66．5pg／mL（IQR：50．0～91．0 pg／mL）、135．9 pg／mL （IQR：54．0～556．3 pg／mL ）。 PCP 환자혈장 BG 적평균수평시（1022．8±982．6）pg／mL ，명현고우 PC 정식[（74．7±33．6）pg／mL]화비PC정식[（562．7±934．9）pg／mL]환자혈장BG적평균수평，차이유통계학의의（P＜0．05）。이151．5 pg／mL위양성림계치시，혈장BG진단PCP적민감성、특이성、양성예측치화음성예측치분별시96．0％、74．0％、64．9％화97．4％。이혈장BG작위PCP적진단방법시，AUC위0．89。결론혈장BG가이작위PCP적일개조기진단지표，동시가이근거BG결과감별PCP혹PC정식。
Objective To explore the clinical value of plasma 1 ,3‐β‐D glucan in the diagnosis of Pneumocystis carinii pneumonia(PCP) .Methods 50 patients with PCP ,50 patients with Pneumocystis carinii(PC) colonization and contemporaneous 50 patients without PC colonization were recruited as the study subjects and tested for plasma 1 ,3‐β‐D glucan(BG) .Results Median plasma BG in the PCP patients was 698 .5 pg/mL [interquartile range(IQR):184 .4-1 256 .0 pg/mL] ,which was higher than 66 .5 pg/mL(IQR:50 .0-91 .0 pg/mL) in the PC colonization and 135 .9 pg/mL(IQR:54 .0-556 .3 pg/mL) in the PC noncolonization patients ,respectively .The average level of plas‐ma BG in the PCP patients was (1 022 .8 ± 982 .6)pg/mL ,which was also higher than (74 .7 ± 33 .6)pg/mL and (562 .7 ± 934 .9)pg/mL in the PC colonization and PC noncolonization patients ,respectively .The difference of the av‐erage levels among three groups was statistically significant(P< 0 .05) .With 151 .5 pg/mL as the positive critical value ,the sensitivity ,specificity ,positive and negative predictive values of plasma BG for diagnosing PCP were 96 .0% ,74 .0% ,64 .9% and 97 .4% respectively .With plasma BG as the diagnostic method of PCP ,the area under the curve(AUC) of receiver operating characteristic(ROC) curve was 0 .89 .Conclusion The plasma BG can be used as an early diagnostic indicator of PCP ,which also can differentiate PCP from PC colonization .