本文選題：肺真菌感染 + 肺泡灌洗液　； 參考：《軍事醫(yī)學》2016年03期

【摘要】：目的檢測疑診為肺部侵襲性真菌感染(IFI)患者的支氣管肺泡灌洗液(BALF)和血清半乳甘露聚糖(galacto-mannan,GM)、血清(1,3)-β-D葡聚糖[(1,3)-beta-D-glucan,G test]并對BALF進行真菌培養(yǎng)鑒定,評估上述實驗診斷方法對臨床深部真菌感染的診斷效率。方法回顧性分析148例IFI疑診患者,總結(jié)血清/BALF GM、血清G試驗和真菌培養(yǎng)結(jié)果,分別評估其敏感性、特異性、陽性預測值、陰性預測值和聯(lián)合檢測對IFI的診斷價值。結(jié)果 148例病例中臨床診斷為IFI有48例,臨床排除100例,在48例IFI患者中,血清GM陽性3例,BALF GM陽性25例,G試驗陽性31例,真菌培養(yǎng)陽性30例。聯(lián)合檢測敏感性91.6%、特異性70.0%、陽性預測值59.5%、陰性預測值94.6%,聯(lián)合檢測大幅度提高了其診斷敏感性。結(jié)論聯(lián)合檢測GM、G試驗和真菌培養(yǎng)鑒定能提高IFI診斷敏感性,對肺部IFI具有較好的診斷價值。
[Abstract]:Objective to detect the bronchoalveolar lavage fluid (BALFF), galacto-mannanus (GMN) and 尾 -D-glucanG test (尾 -D-glucanG test) of patients suspected of pulmonary invasive fungal infection (IFI), and to identify the fungal culture of BALF.To evaluate the diagnostic efficiency of the above methods for clinical deep fungal infection.Methods 148 patients with suspected IFI were analyzed retrospectively. The results of serum / BALF GMs, serum G test and fungal culture were analyzed. The sensitivity, specificity, positive predictive value, negative predictive value and combined detection were evaluated for the diagnosis of IFI.Results among 148 cases, 48 cases were diagnosed as IFI and 100 cases were clinically excluded. Among 48 cases of IFI, 3 cases were positive for serum GM and 31 cases were positive for G test, and 30 cases were positive for fungal culture.The sensitivity, specificity, positive predictive value and negative predictive value were 91.6%, 70.0%, 59.5% and 94.6%, respectively.Conclusion combined detection of GMM-G and fungal culture can improve the sensitivity of IFI diagnosis and have a good diagnostic value for pulmonary IFI.
【作者單位】： 安徽醫(yī)科大學解放軍307臨床學院;軍事醫(yī)學科學院附屬醫(yī)院檢驗科;
【基金】：國家科技重大專項資助項目(2013ZX10004203) 國家重大科學儀器設備開發(fā)專項(2012YQ18011708)
【分類號】：R519

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