血清(1,3)-β-D-葡聚糖检测对深部真菌感染的诊断价值

张丽; 邓丽华; 许晶晶

doi:10.13898/j.cnki.issn.1000-2200.2017.01.033

血清(1,3)-β-D-葡聚糖检测对深部真菌感染的诊断价值

Value of the serum(1,3)-β-D-glucan assay in the diagnosis of invasive fungal infection

摘要

摘要: 目的：研究血清中（1，3）-β-D-葡聚糖检测对深部真菌感染的临床意义。方法：回顾性分析1 100例住院患者检测血清（1，3）-β-D-葡聚糖（真菌G试验）结果。结果：真菌G试验灵敏度为78.0%，特异度为89.9%，阳性预测值74.8%，阴性预测值91.4%，真菌G试验与临床诊断结果差异有统计学意义（χ²=491.25，P<0.01）。真菌培养灵敏度为48.9%，特异度为92.3%，阳性预测值71.0%，阴性预测值82.5%，真菌培养与临床诊断结果差异有统计学意义（χ²=239.34，P<0.01）。结论：真菌G试验的检测方法快速、阴性预示值高。传统的真菌培养耗时长，特异性虽高，但标本取材易受污染。建议临床对疑似深部真菌感染时，同时进行真菌G试验和病原培养以提高诊断的敏感性和特异性。

Abstract: Objective: To investigate the clinical value of the serum(1,3)-β-D-glucan assay in the diagnosis of invasive fungal infection.Methods: The serum levels of(1,3)-β-D-glucan in 1 100 patients were retrospectively analyzed.Results: The sensitivity,specificity,positive predictive value and negative predictive value of the(1,3)-β-D-glucan assay were 78.0%,89.9%,74.8% and 91.4%,respectively,the difference between the result of fungal G test and clinical diagnosis was statistically significant(χ²=491.25,P<0.01).The sensitivity,specificity,positive predictive value and negative predictive value of fungal culture were 48.9%,92.3%,71.0% and 82.5%,respectively,the difference between the result of fungal G test and clinical diagnosis was statistically significant(χ²=239.34,P<0.01).Conclusions: The(1,3)-β-D-glucan assay is rapid and high negative predictive value.The conventional fungal culture is long time consuming,high specificity and susceptibility to contamination.The fungal G test combined with fungal culture can improve the sensitivity and specificity of the clinical diagnosis in suspect invasive fungal infection.

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