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目的评价和比较血清半乳甘露聚糖(GM)浓度测定和PCR结合反向斑点杂交实验在侵袭性肺曲霉病(IPA)早期诊断中的临床价值。方法用酶联免疫吸附试验(ELISA)检测血清中GM的浓度;PCR结合反向斑点杂交法检测各组小鼠血清、肺泡灌洗液、肺组织中的曲霉菌DNA。结果 ELISA法测定GM浓度中,实验组血清、BALF的GM实验敏感性、特异性与对照组间差异有统计学意义(P<0.05);反向斑点杂交检测血清、肺泡灌洗液、肺组织中曲霉菌DNA含量,实验组阳性率明显高于对照组(P<0.05)。用血清标本的反向斑点杂交实验与GM实验、组织病理阳性率进行比较,组织病理的阳性率最高,其次是反向斑点杂交。三种方法的差别均有统计学意义(P<0.05)。结论 GM-ELI-SA检测是一项较灵敏、快速的诊断方法,反向斑点杂交实验在IPA早期诊断上的作用优于GM实验。
Objective To evaluate and compare the clinical value of serum galactomannan (GM) concentration and PCR combined with reverse dot blot hybridization in the early diagnosis of invasive pulmonary aspergillosis (IPA). Methods The concentration of GM in serum was detected by enzyme - linked immunosorbent assay (ELISA). Aspergillus DNA in serum, alveolar lavage fluid and lung tissue were detected by PCR and reverse dot blot hybridization. Results The sensitivity and specificity of GM assay in serum and BALF in experimental group were significantly lower than those in control group (P <0.05) by ELISA method. The levels of serum, alveolar lavage fluid and lung tissue Aspergillus oryzae DNA content, the experimental group was significantly higher than the control group (P <0.05). The positive rate of histopathology was the highest with the reverse dot blot hybridization test of serum samples and GM test, the positive rate of histopathology, followed by reverse dot blot hybridization. The differences of the three methods were statistically significant (P <0.05). Conclusion The detection of GM-ELI-SA is a sensitive and rapid diagnostic method. The reverse dot blot hybridization assay is superior to GM in the early diagnosis of IPA.