论文部分内容阅读
目的观察侵袭性肺曲霉菌感染患者抗真菌治疗前后肺泡灌洗液及血清中半乳甘露聚糖(GM)的水平变化、CT影像学特征及血清中性粒细胞数与GM试验阳性率之间的关系,患者血清中性粒细胞值与GM试验阳性率之间的关系。方法连续性纳入60例确诊侵袭性肺曲霉菌感染患者,观察抗真菌治疗前后肺泡灌洗液和血清GM试验动态水平变化。单因素Logistic回归分析CT侵犯肺叶数、空气新月征、晕轮征、血清中性粒细胞值与GM的关系。结果抗真菌治疗前患者肺泡灌洗液GM平均值均高于血清GM平均值(0.62±0.08mg/L,60.0%;0.51±0.07mg/L,31.6%)。同抗真菌治疗前比,患者抗真菌治疗后1个月、2个月、3个月、6个月肺泡灌洗液GM值快速降低(P<0.05),而血清GM数值缓慢降低,仅在第3个月、第6个月降低(P<0.05)。患者CT侵犯肺叶数、晕轮征与肺泡灌洗液、血清中性粒细胞值GM试验阳性率显著相关。结论肺泡灌洗液及血清GM试验可作为IFD疾病诊断及治疗的重要辅助指标。CT影像学特征、血清中性粒细胞值与GM试验阳性率显著相关。
Objective To observe the changes of the level of galactomannan (GM) in bronchoalveolar lavage fluid and serum before and after antifungal therapy in patients with invasive pulmonary aspergillosis, the relationship between CT imaging features and the positive rate of serum neutrophil number and GM test The relationship between serum neutrophil values and the positive rate of GM test. Methods Sixty consecutive patients with confirmed invasive pulmonary aspergillosis were enrolled in this study. The dynamic changes of GM and GM-CSF in serum before and after antifungal therapy were observed. Logistic regression analysis was used to analyze the relationship between lung CT count, air crescent sign, halo sign, serum neutrophil count and GM. Results Before antifungal therapy, the mean of GM in bronchoalveolar lavage fluid was higher than that of serum GM (0.62 ± 0.08mg / L, 60.0%; 0.51 ± 0.07mg / L, 31.6%). Compared with the antifungal treatment, the GM value of bronchoalveolar lavage fluid decreased rapidly at 1 month, 2 months, 3 months and 6 months after antifungal therapy (P <0.05), while the serum GM value decreased slowly The third month, the sixth month decreased (P <0.05). The CT number of lung lesions in patients with CT, halo sign and bronchoalveolar lavage fluid, serum neutrophil GM test positive rate was significantly correlated. Conclusions The bronchoalveolar lavage fluid and serum GM test can be used as important auxiliary indicators for the diagnosis and treatment of IFD. CT imaging features, serum neutrophil values and GM test positive rate was significantly correlated.