本文選題：半乳甘露聚糖 + 慢性阻塞性肺疾病��； 參考：《醫(yī)學(xué)研究生學(xué)報(bào)》2017年04期

【摘要】：目的目前關(guān)于血清半乳甘露聚糖(GM)檢測(cè)在侵襲性曲霉感染中的診斷價(jià)值,主要集中在血液病患者、粒細(xì)胞缺乏患者中,而對(duì)慢性阻塞性肺疾病(COPD)并發(fā)侵襲性肺曲霉病(IPA)的相關(guān)研究較少。文中旨在研究在COPD并發(fā)IPA患者中血清GM實(shí)驗(yàn)的診斷價(jià)值。方法選取2015年3月至2016年9月在南京軍區(qū)南京總醫(yī)院呼吸與危重癥醫(yī)學(xué)科住院資料完整的COPD患者60例,其中IPA組(確診和臨床診斷IPA患者)19例,非IPA組(非IPA患者)41例。采用ELISA法檢測(cè)血清GM,評(píng)價(jià)其對(duì)COPD合并IPA患者的診斷價(jià)值;同時(shí)比較IPA組7名治療有效患者治療前后的GM值變化。結(jié)果當(dāng)血清GM取0.5為陽(yáng)性界值時(shí),其敏感性、特異性、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值分別為57.9%、95.1%、84.6%、83.0%,特異性較高,但敏感性不高。7例COPD合并IPA患者治療后GM值較治療前有顯著下降[(0.30±0.21)vs(1.48±1.37),P=0.004]。結(jié)論血清GM檢測(cè)在COPD合并IPA患者中的診斷價(jià)值有限,但是血清GM動(dòng)態(tài)監(jiān)測(cè)有利于掌握患者病情變化。
[Abstract]:Objective to evaluate the diagnostic value of serum galactomannan in invasive aspergillus infection, mainly in patients with hematologic disease and granulocytosis. However, there were few studies on the incidence of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to study the diagnostic value of serum GM test in patients with COPD complicated with IPA. Methods from March 2015 to September 2016, 60 COPD patients with complete data of respiratory and critical care in Nanjing General Hospital of Nanjing military region were selected, including 19 patients with IPA diagnosed and clinically diagnosed in IPA group and 41 patients with non-IPA patients in non-IPA group. To evaluate the diagnostic value of ELISA in patients with COPD and IPA, and to compare the changes of GM in 7 effective patients with IPA before and after treatment. Results the sensitivity, specificity, positive predictive value and negative predictive value of serum GM were 57.9 and 84.60.The specificity was higher, but the sensitivity was not high, but the GM value of IPA patients after treatment was significantly lower than that before treatment [0.30 鹵0.21)vs(1.48 鹵1.37P0.004]. Conclusion Detection of serum GM is of limited diagnostic value in patients with COPD and IPA, but dynamic monitoring of serum GM is helpful to grasp the changes of patients' condition.
【作者單位】： 南方醫(yī)科大學(xué)金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)呼吸與危重癥醫(yī)學(xué)科;
【基金】：國(guó)家自然科學(xué)基金(81330035) 國(guó)家科技部支撐計(jì)劃課題(2015BAI12B00)
【分類號(hào)】：R519;R563.9

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