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目的:探讨支气管肺泡灌洗液(BALF)半乳甘露聚糖(GM)的检测对侵袭性肺曲霉病(IPA)的早期诊断价值。方法:选择85例临床资料完整的患者,分为IPA组与对照组。采用酶联免疫夹心法半定量测定BALF GM和血清GM抗原,用统计学方法了解BALF GM检测的诊断效率。结果:以GM值为0.5作为阳性界值时,BALF GM和血清GM检测的敏感度、特异度、阳性预测值和阴性预测值分别为85.7%、81.2%、60.0%、94.5%;52.4%、89.1%、52.2%、95.0%。以GM值为1.0作为阳性界值时,BALF GM和血清GM的特异度、阳性预测值均可达100.0%,但BALF GM检测的敏感度和阴性预测值(66.7%和90.1%)明显高于血清GM检测(28.6%和81.0%)。结论:BALF GM试验以1.0作为阳性界值,对IPA的早期诊断有重要的应用价值。
Objective: To investigate the early diagnosis of invasive pulmonary aspergillosis (IPA) in bronchoalveolar lavage fluid (BALF) galactomannan (GM). Methods: A total of 85 patients with complete clinical data were selected and divided into IPA group and control group. BALF GM and serum GM antigens were semi-quantitatively determined by enzyme-linked immunosorbent assay (ELISA), and the diagnostic efficiency of BALF GM assay was statistically analyzed. Results: The sensitivity, specificity, positive predictive value and negative predictive value of BALF GM and serum GM were 85.7%, 81.2%, 60.0%, 94.5% and 52.4% respectively when the GM value was 0.5. 89.1%, 52.2%, 95.0%. The specificity and positive predictive value of BALF GM and serum GM reached 100.0% when GM value was 1.0, but the sensitivity and negative predictive value of BALF GM (66.7% and 90.1%) were significantly higher than those of GM Serum GM test (28.6% and 81.0%). Conclusion: BALF GM test with 1.0 as a positive cutoff value has an important value in the early diagnosis of IPA.