血清GM试验和常规真菌检测对肺曲霉菌感染的诊断价值
Diagnostic Value of Serum Galactomannan Test and Routine Fungal Detection in Clinical Pulmonary Aspergillosis Infection
陈世敏 1罗南萍 1公衍文1
作者信息
- 1. 济南军区总医院实验诊断科,250031
- 折叠
摘要
目的:探讨血清半乳甘露聚糖(galactomannan,GM)试验和常规真菌检测对肺曲霉菌感染的诊断价值.方法:对2012.06-2012.12间住院患者中确诊、临床诊断和拟诊肺曲霉病的437位患者的痰或肺泡灌洗液标本进行直接涂片镜检、真菌培养检测;血清标本则通过ELISA检测GM水平,并对检测结果进行了统计分析.结果:标本直接涂片镜检对肺曲霉菌感染诊断的特异性和阳性结果预测值均为100.0%,但敏感性仅为7.3%;标本经过培养后检测到肺曲霉菌生长的敏感性为31.3%,特异性高达99.2%,但是真菌培养组与直接涂片镜检组的阴性预测值水平均偏低;GM组对肺曲霉菌感染诊断的特异性和阳性预测值有所下降,但敏感性和阴性预测值有明显提高,分别达79.9%和86.0%.结论:实验室检查结果证实,血清GM试验和真菌涂片及培养联检有助于肺曲霉菌感染的诊断.
Abstract
Objective To explore the diagnostic value of serum galactomannan test and routine fungal detection in pulmonary as-pergillosis infection. Method From June 2012 to December 2012, Broncho-alveolar lavage fluid or sputum from the 437 aspergillosis patients of definite diagnosis, clinical diagnosis and suspect diagnosis in our hospitalized patients were made traditional direct microscopy and fungal culture. And the serum from these patients were detected the aspergillus antigen of galactomannan ( GM) by ELBA. Results The specimen directly smear and microscopic examination on pulmonary aspergUlus infection, diagnostic specificity and predictive value of a positive result was 100% , but the sensitivity presented only 7.3% ; Specimens after culture, the sensitivity of detection the aspergillus growth was 31.3% , the specificity showed as high as 99.2% , but the fungal culture group and the direct smear microscopic erarmination group's negative predictive levels were low;The diagnostic specificity and positive predictive value of GM group on pulmonary Aspergillus infection were decreased, but the sensitivity and negative predictive value increased to 79.9% and 86% respectively. Conclusion Laboratory findings verified serum GM test and fungal smear microscopic examination and culture combined detection might be helpful to the clinical diagnosis of pulmonary aspergillosis.
关键词
真菌培养/半乳甘露聚糖/肺曲霉菌感染Key words
fungal culture galactomanuan pulmonary aspergillosis infection引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据