论文部分内容阅读
目的核酸序列依赖性扩增(nucleic acid sequence-based amplification,NASBA)、Real-time PCR及GM试验在侵袭性曲霉菌感染中的诊断价值。方法收集2013年11月~2014年6月临床上曲霉菌感染高危病患的血液标本80例,并根据EORTC/MSG诊断标准分为确诊组8例,拟诊组26例,非感染组46例,分别利用NASBA、real-time PCR及GM试验进行检测,计算3种方法的诊断指标并分析评价。结果 NASBA、real-time PCR及GM试验3种方法的灵敏度分别为76.47%、67.65%、52.94%,特异度分别为80.43%、89.13%、80.43%。联合诊断结果显示,NASBA与real-time PCR串联方案有最好的特异度(100%)及阳性预测值(100%);NASBA与real-time PCR并联方案则最为灵敏(94.12%)。结论 NASBA用于诊断IA最为敏感,而real-time PCR则最为特异,GM试验的表现差于前两者。联合应用的诊断策略,在特定情况下提高临床早期诊断IA的准确性。
Objective The diagnostic value of nucleic acid sequence-based amplification (NASBA), real-time PCR and GM test in invasive Aspergillus infection. Methods Eighty patients with clinically high-risk Aspergillus infection were collected from November 2013 to June 2014. According to the diagnostic criteria of EORTC / MSG, 8 cases were included in the diagnosis group, 26 cases in the suspected group and 46 cases in the non-infected group , Respectively, using NASBA, real-time PCR and GM test to detect, calculate the diagnostic indicators of the three methods and analysis and evaluation. Results The sensitivities of three methods of NASBA, real-time PCR and GM were 76.47%, 67.65% and 52.94% respectively, and the specificity were 80.43%, 89.13% and 80.43% respectively. The combined diagnosis showed that NASBA had the highest specificity (100%) and positive predictive value (100%) for real-time PCR in tandem, and the most sensitive (94.12%) was NASBA in combination with real-time PCR. Conclusion NASBA is the most sensitive method for the diagnosis of IA, while real-time PCR is the most specific method. The performance of GM test is worse than the former two. Jointly applied diagnostic strategies to improve the accuracy of clinical early diagnosis of IA under specific circumstances.