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目的探讨血浆(1,3)-β-D葡聚糖检测对侵袭性真菌病的早期诊断意义。方法通过回顾性分析105例怀疑侵袭性真菌病的住院患者的血浆(1,3)-β-D葡聚糖含量和真菌培养结果,分别计算两种方法的阳性率及灵敏度、特异度、阳性和阴性预测值。结果侵袭性真菌病患者的血浆(1,3)-β-D葡聚糖检测阳性率和真菌培养阳性率分别是为80.00%和66.67%,两组差异有统计学意义(P<0.05);血浆(1,3)-β-D葡聚糖检测阳性者血浆(1,3)-β-D葡聚糖含量为(62.0±21.34)ng·L-1,阴性者为(5.1±2.03)ng·L-1,两组差异有统计学意义(P<0.05);葡聚糖检测灵敏度和特异度为80.0%和91.7%,葡聚糖检测的阳性预测值和阴性预测值分别为87.8%和85.9%,均较真菌培养高。结论血浆(1,3)-β-D葡聚糖检测方法快速、阳性率高、灵敏度和特异度高,可用于侵袭性真菌病的早期诊断。
Objective To investigate the significance of plasma (1,3) -β-D-glucan in early diagnosis of invasive mycosis. Methods The plasma (1,3) -β-D-glucan contents and fungal culture results of 105 inpatients with suspected invasive fungal diseases were retrospectively analyzed. The positive rate, sensitivity, specificity and positive of the two methods were calculated And negative predictive value. Results The positive rate of plasma (1,3) -β-D-glucan and the positive rate of fungal culture in patients with invasive mycosis were 80.00% and 66.67%, respectively, with significant difference between the two groups (P <0.05). The plasma (1,3) -β-D-glucan level was (62.0 ± 21.34) ng · L-1 in the plasma and the negative was (5.1 ± 2.03) ng · L-1, the difference between the two groups was statistically significant (P <0.05); the sensitivity and specificity of dextran detection were 80.0% and 91.7%; the positive predictive value and negative predictive value of dextran assay were 87.8% And 85.9% higher than those of fungi. Conclusion The detection of plasma (1,3) -β-D-glucan is rapid, with high positive rate and high sensitivity and specificity. It can be used in the early diagnosis of invasive fungal diseases.