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目的探讨血浆(1→3)-β-D葡聚糖作为深部真菌感染早期诊断的意义。方法应用MB-80微生物动态快速检测系统对100例临床疑似深部真菌感染患者抽血作血浆(1→3)-β-D葡聚糖定量检测,并同时用乳胶凝集法作血清假丝酵母菌抗原、曲霉菌抗原、隐球菌抗原的检测,同一时间抽取患者血液和留取患者的痰或中段尿标本进行真菌培养。结果血浆(1→3)-β-D葡聚糖的阳性率75.0%,真菌培养阳性率为63.0%,真菌抗原阳性率为10.0%;真菌培养与(1→3)-β-D葡聚糖阳性率差异无统计学意义(P>0.05),真菌抗原与(1→3)-β-D葡聚糖阳性率差异有统计学意义(P<0.05)。以真菌培养结果作标准,则(1→3)-β-D葡聚糖的灵敏度为96.8%,特异性为62.2%。结论血浆(1→3)-β-D葡聚糖比真菌培养、真菌抗原检测能够更早、更灵敏地反应深部真菌的早期感染。
Objective To investigate the significance of plasma (1 → 3) -β-D-glucan in the early diagnosis of deep fungal infection. Methods 100 patients with clinically suspected deep fungal infection were collected for blood plasma (1 → 3) -β-D-glucan quantitative detection by MB-80 rapid dynamic test system. At the same time, latex agglutination method was used for Candida albicans Antigen, Aspergillus antigens, cryptococcal antigen detection, the same time the patient’s blood and patients with sputum or middle urine samples taken for fungal culture. Results The positive rate of plasma (1 → 3) -β-D-glucan was 75.0%, the positive rate of fungal culture was 63.0% and the positive rate of fungal antigen was 10.0% There was no significant difference in the positive rate of sugar (P> 0.05). The positive rate of fungal antigen and (1 → 3) -β-D-glucan had statistical significance (P <0.05). According to the results of fungal culture, the sensitivity of (1 → 3) -β-D-glucan was 96.8% and the specificity was 62.2%. Conclusion Plasma (1 → 3) -β-D-glucan is more effective than fungal culture in detecting fungal antigen earlier and more sensitively in the early infection of deep fungi.