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目的 探讨巢式聚合酶链反应 (PCR)方法和曲霉菌半乳甘露聚糖抗原酶联免疫吸附试验 (ELISA)检测方法早期诊断侵袭性曲霉菌感染的可行性和临床应用价值。方法 (1)建立侵袭性曲霉菌感染的动物模型 ,收集不同时期实验动物的血样及各脏器标本 ,进行巢式PCR方法的检测。 (2 )对临床确诊或拟诊的侵袭性曲霉菌感染患者的血液标本进行巢式PCR方法的检测 ;对血清标本进行曲霉菌半乳甘露聚糖抗原ELISA方法的检测。结果 (1)动物实验中 ,巢式PCR和血培养阳性率分别为 77 8%和 16 7% ,两者差异具有显著意义 ;灵敏度和特异度分别为 77 8%和 10 0 %。 (2 )在临床确诊或拟诊的侵袭性曲霉菌感染患者的检测中巢式PCR方法的灵敏度和特异度分别为 10 0 %和 83 3% ;曲霉菌半乳甘露聚糖抗原ELISA检测的灵敏度和特异度分别为 5 5 6 %和 88 2 %。结论 巢式PCR方法具有良好的灵敏度和特异性 ,适用于临床早期诊断侵袭性曲霉菌感染。曲霉菌半乳甘露聚糖抗原ELISA检测可用于临床诊断侵袭性曲霉菌菌感染 ,有望辅助或替代传统方法。
Objective To investigate the feasibility and clinical value of nested polymerase chain reaction (PCR) and Aspergillus mold galactomannan antigen enzyme-linked immunosorbent assay (ELISA) in the early diagnosis of invasive Aspergillus infection. Methods (1) To establish an animal model of invasive Aspergillus infection and to collect blood samples from various experimental animals and samples of various organs for nested PCR. (2) The nested PCR method was used to detect the blood samples from patients with invasive aspergillosis clinically diagnosed or suspected to be diagnosed; the serum samples were tested for the Aspergillus oryzae galactomannan antigen ELISA. Results (1) The positive rates of nested PCR and blood culture in animal experiments were 77.8% and 16.7%, respectively, with significant differences. The sensitivity and specificity were 77.8% and 100% respectively. (2) The sensitivity and specificity of the nested PCR method in the clinically diagnosed or asymptomatic invasive aspergillosis patients were 100% and 83 3%, respectively; the sensitivity of Aspergillus oryzae galactomannan antigen ELISA And specificity were 556% and 88 2%, respectively. Conclusion The nested PCR method has good sensitivity and specificity and is suitable for clinical diagnosis of invasive Aspergillus infection. Aspergillus galactomannan antigen ELISA test can be used for clinical diagnosis of invasive Aspergillus infection, is expected to supplement or replace traditional methods.