【摘 要】
：
目的 探讨血清(1,3)-β-D葡聚糖检测(G试验)联合尿真菌培养对泌尿系侵袭性真菌感染(invasive fungal in-fection,IFI)诊断效能的影响.方法 选取2019-05至2020-10武警特色医学中心收治的疑似泌尿系IFI患者135例为研究对象,采集所有患者血清及清洁中段尿标本.采用MB-80微生物快速动态检测系统进行血清G试验,并进行尿真菌培养,以患者临床症状、影像学诊断、抗菌药物使用情况及相应症状转归情况作为诊断IFI的诊断标准,统计G试验、尿真菌培养检测结果,分析二者单独或联
【机 构】
：
300162 天津,武警特色医学中心:检验科;300162 天津,武警特色医学中心:感染性疾病科
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目的 探讨血清(1,3)-β-D葡聚糖检测(G试验)联合尿真菌培养对泌尿系侵袭性真菌感染(invasive fungal in-fection,IFI)诊断效能的影响.方法 选取2019-05至2020-10武警特色医学中心收治的疑似泌尿系IFI患者135例为研究对象,采集所有患者血清及清洁中段尿标本.采用MB-80微生物快速动态检测系统进行血清G试验,并进行尿真菌培养,以患者临床症状、影像学诊断、抗菌药物使用情况及相应症状转归情况作为诊断IFI的诊断标准,统计G试验、尿真菌培养检测结果,分析二者单独或联合诊断的灵敏度、特异度、准确度.结果 本组共135例疑似泌尿系IFI患者,经临床综合诊断确诊为泌尿系IFI患者52例;尿真菌培养检出泌尿系IFI阳性63例;G试验检出泌尿系IFI阳性64例;G试验联合尿真菌培养检出泌尿系IFI阳性43例.尿真菌培养共检出真菌63株,假丝酵母菌属61例,其中白假丝酵母菌最多,共45例(71.43％);2例为曲霉菌属.G试验联合尿真菌培养诊断泌尿系IFI的灵敏度[80.77％(42/52)]、阴性预测值(negative predictive value,NPV)[89.13％(82/92)]与二者单独诊断对比差异无统计学意义;G试验联合尿真菌培养诊断泌尿系IFI的特异度[98.80％(82/83)]、准确度[91.85％(124/135)]、阳性预测值(positive predictive value,PPV)[97.67％(42/43)]、约登(Youden)指数(0.796)均高于二者单独诊断,差异有统计学意义(P<0.05).结论 临床诊断泌尿系IFI时采用G试验联合尿真菌培养,能提高诊断特异度、准确度及阳性预测值.
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