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目的:目的1,3-β-D葡聚糖与半乳甘露聚糖在恶性血液病粒细胞缺乏症患者合并真菌感染的诊断中有重要价值,其对于非粒细胞缺乏患者的诊断价值却少有研究。本研究旨在了解1,3-β-D葡聚糖(G试验)与半乳甘露聚糖(GM试验)对急诊非粒细胞缺乏症患者侵袭性真菌感染的诊断价值。方法:收集2011-01-2017-01期间入住急诊重症监护室的真菌感染高危患者共378例,在抗真菌治疗前检测上述患者的血清G和GM抗原。结果:所有患者被分为确诊组(41例),临床诊断组(16例),拟诊组(59例),排除组(262例)。IFI患者最常见的基础病是糖尿病(21.38%),4.83%的患者无基础病。G试验、GM试验及G/GM试验至少一项阳性的敏感度、特异度、阳性预测值、阴性预测值分别为52.63%、77.86%、34.09%、88.31%;49.12%、87.78%、49.12%、89.86%和70.18%、75.57%、38.46%、92.09%。结论:与粒细胞缺乏症患者相比,单独检测血清G试验或GM试验对非粒细胞缺乏的IFI患者的诊断价值不大。但是,G试验及GM试验仅一项阳性对非粒细胞缺乏的IFI患者的诊断价值更大。
Objective: The purpose of 1,3-β-D glucan and galactomannan in patients with hematologic malignancies agranulocytosis complicated with fungal infection diagnosis of great value, its non-neutropenic patients with less diagnostic value Have research. The purpose of this study was to investigate the diagnostic value of 1,3-β-D-glucan (G test) and galactomannan (GM test) in the diagnosis of invasive fungal infection in emergency non-agranulocytosis patients. METHODS: A total of 378 high risk patients with fungal infections admitted to the emergency intensive care unit during the period from January 2011 to January 2017-01 were enrolled. Serum G and GM antigens were collected before antifungal treatment. Results: All the patients were divided into the diagnosis group (41 cases), the clinical diagnosis group (16 cases), the trial group (59 cases) and the exclusion group (262 cases). The most common underlying disease in patients with IFI is diabetes (21.38%), and 4.83% of patients have no underlying disease. The sensitivity, specificity, positive predictive value and negative predictive value of at least one of G test, GM test and G / GM test were 52.63%, 77.86%, 34.09%, 88.31%, 49.12%, 87.78%, 49.12% , 89.86% and 70.18%, 75.57%, 38.46% and 92.09% respectively. Conclusion: Compared with patients with agranulocytosis, the serum G test or GM test alone is of little value in the diagnosis of non-granulocytic IFI. However, only one positive test in the G and GM tests has a greater diagnostic value for non-granulocytic IFI patients.