Diagnostic value of serum IL-17 combined serum GM test and BALF-GM test for invasive pulmonary aspergillosis in ICU
Objective To explore the value of combined detection for early diagnosis of invasive pulmonary aspergillosis(IPA)in ICU by monitoring the changes of serum IL-17 level,serum GM test and bronchoalveolar lavage fluid(BALF)-GM test in patients with pulmonary infection at high risk of fungal invasion in ICU.Methods Sixty patients with pulmonary infection and risk factors related to fungal infection were divided into two groups,and the test group was confirmed and clinically diagnosed IPA group of 30 cases.The control group was proposed IPA group of 30 cases.Age,severity score,blood routine(absolute lymphocyte count),serum IL-17,serum GM test,BALF-GM test,BALF fungal culture identification and cytological examination,and pulmonary imaging were performed,fol-lowed by data collection.The serum IL-17 levels in each group were measured using electro-chemiluminescence,and the GM test was performed using enzyme-linked immunosorbent assay.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to analyze the diagnostic efficacy of serum IL-17,serum GM test,and BALF-GM test for IPA,and further evaluate the diag-nostic efficacy of the combined testing of the three indicators for early diagnosis of IPA.The combinations of two indicators:serum GM test+BALF-GM test,serum IL-17+serum GM test,and serum IL-17+BALF-GM test.Results The levels of serum IL-17,serum GM test and BALF-GM test in the experimental group were significantly higher than those in the control group(P<0.05);logis-tic regression analysis and ROC curve analysis showed that the sensitivity and specificity of serum IL-17 combined with BALF-GM test for IPA diagnosis was 86.7%and the specificity was80.0%,and the area under the curve was0.852.It was higher than serum IL-17 combined with serum GM and serum GM combined with BALF-GM.Conclusion Serum IL-17 levels are highly expressed in IPA pa-tients and combined with the BALF-GM test can enhance the early diagnostic value of IPA.
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