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本研究试图通过测量血清与支气管肺泡灌洗液中1,3-β-D葡聚糖浓度,分析应用支气管肺泡灌洗液G试验作为早期诊断早产儿肺部侵袭性真菌感染的可行性。选取2014年2月至2016年9月经确诊为侵袭性真菌感染的早产患儿42例作为观察组,将同期生产于我院的健康早产儿61例作为对照组。在清晨时间采集观察组与对照组早产儿的静脉血与分支气管肺泡灌洗液,将静脉血离心取上层血清待用,比较血清与支气管肺泡灌洗液的G试验的表达情况、阳性率及灵敏性。观察组早产儿经测量后,支气管肺泡灌洗液以及血浆中的1,3-β-D葡聚糖水平与健康早产儿比较有差异,说明通过G实验检测1,3-β-D葡聚糖有诊断早产儿侵袭性真菌感染的价值;观察组早产儿的支气管肺泡灌洗液G试验阳性率为83.33%,血浆G试阳性率为64.29%,x~2值为3.941,p值为0.047;支气管肺泡灌洗液G试验灵敏度为89.47%,血浆G试验灵敏度为65.79%,二者x~2值为6.138,p值为0.013。本研究的结果认为支气管肺泡灌洗液G试验可以有效、敏感的测定早产儿体内1,3-β-D葡聚糖的表达情况,应用于早产儿早期诊断肺部侵袭性真菌感染具有临床价值。
This study attempts to analyze the use of bronchoalveolar lavage fluid G test as an early diagnosis of lung invasive fungal infection in preterm infants by measuring the concentration of 1,3-β-D-glucan in serum and bronchoalveolar lavage fluid. Forty-two premature infants diagnosed with invasive fungal infection from February 2014 to September 2016 were selected as the observation group, and 61 healthy preterm infants in our hospital were selected as the control group. Venous and branch bronchoalveolar lavage fluid of observation group and control group were collected in early morning, and the venous blood was centrifuged to take the upper serum for later use. The G test of serum and bronchoalveolar lavage fluid was compared and the positive rate and Sensitivity. In the observation group, the levels of 1,3-β-D-glucan in bronchoalveolar lavage fluid and plasma were different from those in healthy preterm infants after measurement in preterm infants, indicating that G-test was used to detect 1,3-β-D The positive rate of bronchial alveolar lavage fluid G in preterm infants in observation group was 83.33%, the positive rate of plasma G test was 64.29%, the value of x ~ 2 was 3.941, the p value was 0.047 The sensitivity of G test in bronchoalveolar lavage fluid was 89.47% and the sensitivity of plasma G test was 65.79%. The two values of x ~ 2 were 6.138 and the p value was 0.013. The results of this study that the bronchial alveolar lavage G test can be effective and sensitive determination of premature infants 1,3-β-D-glucan expression, early diagnosis of lung invasive fungal infection with clinical value .