血浆(1,3)-β-D-葡聚糖检测对呼吸机相关性肺部真菌感染诊断的临床价值研究
投稿时间:2014-09-02  修订日期:2014-09-05  点此下载全文
引用本文:封凯旋,马斌,黄晓丽,凌杰兵,苟鑫,周淏,崔轶坤,罗向阳.血浆(1,3)-β-D-葡聚糖检测对呼吸机相关性肺部真菌感染诊断的临床价值研究[J].医学研究杂志,2015,44(3):115-118
DOI: 10.3969/j.issn.1673-548X.2015.03.032
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作者单位
封凯旋 201599 上海市第六人民医院金山分院 
马斌 201599 上海市第六人民医院金山分院 
黄晓丽 201599 上海市第六人民医院金山分院 
凌杰兵 201599 上海市第六人民医院金山分院 
苟鑫 201599 上海市第六人民医院金山分院 
周淏 201599 上海市第六人民医院金山分院 
崔轶坤 201599 上海市第六人民医院金山分院 
罗向阳 201599 上海市第六人民医院金山分院 
基金项目:上海市金山区科委课题(2012-3-18)
中文摘要:目的 研究血浆(1, 3)-β-D-葡聚糖检测对呼吸机相关性肺部真菌感染诊断的临床价值。方法 选择ICU进行有创机械通气48h以上, 临床确诊均为肺部真菌感染的34例患者作为试验组, 以33例无真菌感染的健康献血者作为对照组。对两组患者抽取静脉血做(1, 3)-β-D-葡聚糖检测(G试验), 将试验结果与病原学诊断结果相比较, 计算G试验的敏感度、特异性、阳性预测值、阴性预测值及准确性。结果 试验组患者血浆(1, 3)-β-D-葡聚糖定量检测有32例阳性, 血浆(1, 3)-β-D葡聚糖含量为96.10±12.31pg/ml;对照组患者血浆(1, 3)-β-D-葡聚糖定量检测有3例阳性, 血浆(1, 3)-β-D-葡聚糖含量为4.30±1.77pg/ml。两组比较差异有统计学意义(P<0.05)。血浆(1, 3)-β-D-葡聚糖检测的敏感度与特异性为94.11%、90.90%;血浆(1, 3)-β-D-葡聚糖检测的阳性预测值与阴性预测值为91.43%、93.75%。结论 血浆(1, 3)-β-D-葡聚糖检测诊断呼吸机相关性肺部真菌感染具有快速、可靠等优点, 有较高的敏感度、特异性和准确性。
中文关键词:肺部真菌感染  呼吸机相关性  (1,3)-β-D-葡聚糖
 
Clinical Value of Plasma (1,3)-β-D-Glucan Detection in Ventilator-Associated Pulmonary Fungal Infection Diagnosis
Abstract:Objective To study clinical value of plasma (1, 3)-β-D-glucan detection in ventilator-associated pulmonary fungal infection diagnosis. Methods Thirty four patients diagnosed as pulmonary fungal infection were selected as a test group. All patients in the test group have experienced over 48 hour's invasive mechanical ventilation in ICU. Another 33 healthy people with no fungal infections were selected as a control group. (1, 3)-β-D-glucan detection (G test) was conducted in both groups using venous blood as the test samples. Test results were compared with the results of etiological diagnosis to assess the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of G test. Results Thirty two positive cases were found in the test group through quantitative detection of (1, 3)-β-D-glucan in the plasma. And, the average content of (1, 3)-β-D-glucan in the plasma was 96.10±12.31pg/ml. While in the control group, just 3 positive cases were detected, with an average content of (1, 3)-β-D-glucan in the plasma of 4.30±1.77pg/ml. Statistically significant was observed between the two groups (P<0. 05). The sensitivity, specificity, positive and negative predictive value of plasma (1, 3)-β-D-glucan detection was 94.11%, 90.90%, 91.43% and 93.75%, respectively. Conclusion The method of plasma (1, 3)-β-D-glucan detection in ventilator-associated pulmonary fungal infection diagnosis was fast and reliable, and has a higher sensitivity, specificity and accuracy.
keywords:Pulmonary fungal infection  Ventilator-associated  (1,3)-β-D-glucan
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