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目的:评价血清1,3-β-D葡聚糖(G)和半乳甘露聚糖(GM)抗原联合检测对血液肿瘤患者侵袭性真菌感染(IFI)的早期诊断价值。方法:42例中性粒细胞减少伴发热,经广谱抗生素治疗无效的血液病患者,根据临床回顾性诊断标准定义阳性和阴性病例。采用ELISA试剂盒检测患者血清G和GM,分别计算GM试验和G试验及联合检测的灵敏度、特异度、阳性和阴性预测值。结果:以I值>1.0为GM试验阳性,G浓度>60 pg/L为G试验阳性计算,GM试验和G试验联合检测的灵敏度、特异度、阳性和阴性预测值77.8%,90.3%,82.4%,87.5%;G试验的灵敏度和阳性预测值高,但GM试验的特异度高。结论:GM试验和G试验联合检测提高试验的敏感度,减少了假阴性的发生,对早期诊断IFI有一定的临床意义。
OBJECTIVE: To evaluate the early diagnostic value of combined detection of serum 1,3-β-D-glucan (G) and galactomannan (GM) antigen for invasive fungal infection (IFI) in patients with hematological malignancies. Methods: 42 cases of neutropenia with fever, the broad-spectrum antibiotics ineffective hematological disease, according to clinical diagnostic criteria to define the positive and negative cases. Serum G and GM were measured by ELISA kit, and the sensitivity, specificity, positive and negative predictive value of GM test, G test and combined test were calculated. Results: The sensitivity, specificity, positive and negative predictive values of 77.8%, 90.3%, 82.4 for the combined test of GM test and G test were calculated based on the positive G test with I value> 1.0 as GM test and G concentration> 60 pg / L as G test %, 87.5%. The sensitivity and positive predictive value of G test were high, but the specificity of GM test was high. Conclusion: The combination of GM test and G test can increase the sensitivity of the test and reduce the incidence of false negatives. It is of clinical significance for the early diagnosis of IFI.