本文選題：1 + 3-β-D-葡聚糖�。� 參考：《新疆醫(yī)科大學》2013年碩士論文

【摘要】：目的：評價血漿1，3-β-D葡聚糖檢測對早期診斷臨床侵襲性深部真菌感染(IFI)的價值。方法：回顧性分析2011年6月至2012年11月期間收住新疆醫(yī)科大學第一附屬醫(yī)學院呼吸內(nèi)科、呼吸重癥監(jiān)護室和感染科的滿足以下入選標準：（1）根據(jù)中國IFI工作組制定的《血液�。瘣盒阅[瘤患者侵襲性真菌感染的診斷標準與治療原則(第三次修訂)》標準，明確診斷IFI的患者或是臨床診斷IFI的患者；（2）在接受抗真菌藥物治療前已完善血漿G實驗和（或）GM實驗的患者，，共66例。同時在所有的住院患者中，根據(jù)IFI組的66位患者的年齡、性別、基礎(chǔ)疾病分別配對，此66位非IFI患者,設(shè)為對照組。應(yīng)用MB-80微生物快速動態(tài)監(jiān)測系統(tǒng)及GKT-1M Set動態(tài)真菌檢測試劑盒血漿檢測(l，3)-β-D-葡聚糖含量。將血漿BG濃度大于20.0pg/ml定義為陽性。使用由廣州科祺生物技術(shù)開發(fā)技術(shù)有限公司提供的曲霉菌抗原酶免試劑盒（96T）檢測半乳甘露聚糖。并計算出G實驗診斷IFI的敏感性、特異性和陽性預(yù)測值以及陰性預(yù)測值。以及GM實驗對于IA的的敏感性、特異性以及陽性預(yù)測值和陰性預(yù)測值。結(jié)果：明確診斷為侵襲性真菌的患者菌種分布仍以假絲酵母菌感染和煙曲霉感染為主，其中假絲酵母菌感染，又以白色假絲酵母菌為主；IFI組的血漿（1，3）-β-D葡聚糖含量為（169.73±164.34）pg/nl，非IFI組的血漿（1，3）-β-D葡聚糖含量為(12.58±9.03)pg/nl，兩組相比較存在顯著統(tǒng)計學差異(t=5.66，P0.05)。根據(jù)四格表法計算的可得到G實驗診斷侵襲性真菌感染其敏感度68.18%，特異度77.27%，陽性預(yù)測值75.00%，陰性預(yù)測值70.83%。結(jié)論：1.血漿BG檢測適用于早期診斷假絲酵母菌和曲霉菌引起的臨床深部組織感染，可協(xié)助臨床醫(yī)生早期診斷用常規(guī)方法難以確診的侵襲性真菌感染。2.血漿BG的檢測是一項較為特異性的診斷真菌感染的指標，GM檢測為診斷曲霉菌感染的特異性指標；3.血漿BG、GM檢測方法較傳統(tǒng)真菌涂片和培養(yǎng)法具有簡便、快速及敏感的優(yōu)點。
[Abstract]:Objective: to evaluate the value of plasma 1-3-尾-D glucan in the early diagnosis of invasive deep fungal infection (IFI). Methods: the respiratory department of the first affiliated Medical College of Xinjiang Medical University was retrospectively analyzed from June 2011 to November 2012. The respiratory intensive care unit and the infection department met the following criteria: (1) according to the criteria for diagnosis and treatment of invasive fungal infection in patients with hematologic / malignant tumor, developed by the IFI working Group of China (the third revision), (2) 66 patients who had completed plasma G test and / or GM test before antifungal therapy. Among all the inpatients, 66 patients in IFI group were matched according to age, sex and underlying diseases. 66 non-IFI patients were set as control group. MB-80 microorganism rapid dynamic monitoring system and GKT-1MSet dynamic fungal detection kit were used to detect plasma (lc3)-尾 -Dglucan content. Plasma BG concentration greater than 20.0pg/ml was defined as positive. Galactomannan was detected with Aspergillus antigens enzyme immunoassay kit (96T) provided by Guangzhou Keqi Biotechnology Development Co., Ltd. The sensitivity, specificity, positive predictive value and negative predictive value of G-test in the diagnosis of IFI were calculated. And the sensitivity, specificity, positive predictive value and negative predictive value of GM test for IA. Results: the infection of Candida and Aspergillus fumigatus was still the main infection in the patients diagnosed as invasive fungi, among which Candida cerevisiae and Candida albicans were the main ones. The plasma levels of (1t3)-尾 -D glucan were (169.73 鹵164.34) PG / nl in IFI group and (12.58 鹵9.03) PG / nl in non-IFI group. There was significant difference between the two groups (t 5.66 P 0.05). The sensitivity, specificity, positive predictive value, negative predictive value and negative predictive value were 68.18, 77.27, 75.00 and 70.83, respectively. Conclusion 1. The detection of plasma BG is suitable for the early diagnosis of clinical deep tissue infection caused by Candida cerevisiae and Aspergillus sp. It can assist clinicians in the early diagnosis of invasive fungal infection which is difficult to be diagnosed by conventional methods. The detection of plasma BG is a relatively specific indicator for the diagnosis of fungal infection. GM detection is a specific index for the diagnosis of aspergillus infection. Compared with the traditional fungal smear and culture method, the detection of plasma BGG GM has the advantages of simplicity, rapidity and sensitivity.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R519

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