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血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测诊断侵袭性真菌感染
其他题名Utility of galactomannan enzyme immunoassay and (1,3) β-D-glucan assay in invasive fungal infection
余进; 李若瑜; 高露娟; 鲁巧云; 王晓红
关键词真菌病 血清学试验 甘露聚糖类 葡聚糖类 诊断 Mycoses Serologic Tests Mannaas Glucans Diagnosis
刊名中华医学杂志
2010
DOI10.3760/cma.j.issn.0376-2491.2010.06.004
90期:6页:371-374
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 比较血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测对侵袭性真菌感染的诊断价值.方法 回顾性调查2008年10月至2009年5月北京大学第一医院115例怀疑侵袭性真菌感染的住院患者,根据诊断标准确定是否发生侵袭性真菌感染,分别在不同临界值情况下计算血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖两试验的敏感度、特异度、阳性预测值和阴性预测值,以及二者联合应用后诊断的敏感度、特异度、阳性预测值和阴性预测值.结果 不同临界值,两实验的敏感度、特异度、阳性预测值和阴性预测值存在差异,其中血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测试验分别以0.5和20×10~3pg/L为临界值时,均得到较好的敏感度(分别为54.5%,63.6%)和特异度(分别为77.9%,69.2%),但阳性预测值较低(分别为20.7%和17.9%),阴性预测值较高(分别为94.2%和94.7%).两种方法联合检测后敏感度提高至90.9%,特异度为52.9%.结论 血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测均可用于诊断侵袭性真菌感染,分别以0.5和20×10~3pg/L为临界值时可获得较好的敏感度和特异度,二者联合可以提高诊断的敏感性. Objective To evaluate the performance of the galactomannan emzyme immunoassay (GM test) and (1,3 ) β-D-glucan assay (G test) for the diagnosis of invasive fungal infection (IFI). Methods A retrospective study was performed in 115 hospitalized patients at Peking University First Hospital who were at risk of IFI. Patients were diagnosed as IFI according to revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at different cutoff values for two assays respectively. Two tests were combined to evaluate the changes of sensitivity, specificity, PPV and NPV. Results The best sensitivity (54. 5%, 63.6% )and specificity(77.9% ,69.2% ) were obtained with the cutoff values of 0.5 and 20×10~3 pg/Lin GM test and G test respectively. The PPV were 20.7% and 17.9%, and the NPV were 94.2% and 94.7% respectively. The sensitivity increased to 90.9% and the specificity was 52.9% after a combined utility of two tests. Conclusion The GM test and G tests are both useful in diagnosis of IFI with the cutoff values of0.5 and 20×10~3 pg/L. A better sensitivity is acquired if there is a combined utility of two tests.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/46386
专题北京大学第一临床医学院_皮肤性病科
作者单位真菌和真菌病研究中心,北京大学第一医院皮肤科,100034
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余进,李若瑜,高露娟,等. 血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测诊断侵袭性真菌感染[J]. 中华医学杂志,2010,90(6):371-374.
APA 余进,李若瑜,高露娟,鲁巧云,&王晓红.(2010).血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测诊断侵袭性真菌感染.中华医学杂志,90(6),371-374.
MLA 余进,et al."血清半乳甘露聚糖和血浆(1,3)β-D-葡聚糖检测诊断侵袭性真菌感染".中华医学杂志 90.6(2010):371-374.
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