血浆（1,3）-β -D-葡聚糖检测对血液病患者侵袭性真菌病的诊断价值

doi:10.3969/j.issn.1673-8640.2016.08.009

检验医学 ›› 2016, Vol. 31 ›› Issue (8): 675-678.DOI: 10.3969/j.issn.1673-8640.2016.08.009

血浆（1,3）-β -D-葡聚糖检测对血液病患者侵袭性真菌病的诊断价值

萧晨路, 韩立中, 倪语星

上海交通大学医学院附属瑞金医院临床微生物科,上海 200025

收稿日期:2015-08-16 出版日期:2016-08-31 发布日期:2016-09-01
作者简介:null
作者简介：萧晨路,女,1984年生,硕士,技师,主要从事侵袭性真菌病快速诊断的实验研究。

通讯作者：倪语星,联系电话：021-64370045-600633。
基金资助:
卫生公益性行业科研专项（201002021）

The detection of （1,3）-beta-D-glucosan in hematological patients with invasive fungal disease

XIAO Chenlu, HAN Lizhong, NI Yuxing

Department of Microbiology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China

Received:2015-08-16 Online:2016-08-31 Published:2016-09-01

摘要/Abstract

摘要：

目的评价（1,3）-β-D-葡聚糖（BDG）检测（简称G试验）对恶性血液病患者侵袭性真菌病（IFD）的诊断价值。方法回顾性分析399例血液系统肿瘤患者每周2~3次的血浆G试验数据,以《血液病/恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则（修订版）》中的标准作为判断标准,利用SPSS 11.5统计软件分析G试验对IFD的诊断价值。结果 G试验诊断IFD的敏感性为78.5%,特异性为79.8%,阳性预测值为75.0%,阴性预测值为82.7%。结论血浆BDG水平与IFD感染有直接联系,每周检测2~3次,结合影像学判断方法能帮助诊断和排除IFD,提高IFD临床诊治效果。

关键词: （1,3）- β-D-葡聚糖, 侵袭性真菌病, 血液系统肿瘤

Abstract:

Objective To evaluate the detection of （1,3）-beta-D-glucosan（BDG）（G test） in hematological patients with invasive fungal disease （IFD）. Methods A retrospective study was performed for 399 hematological malignancy patients,plasma G tests were performed for 2-3 times a week. The Principle and Diagnostic Criteria of the Disease of Hematopoietic System/Tumor in Patients with Invasive Fungal Infection（Revised Edition） was used as criteria. The diagnostic significance was evaluated by SPSS 11.5 software. Results The sensitivity of G test was 78.5% for the diagnosis of IFD,the specificity was 79.8%,the positive predictive value was 75.0%, and the negative predictive value was 82.7%. Conclusions Plasma BDG is correlated with IFD. Plasma G test should be taken 2-3 times per week. Combined with medical imaging,G test could improve the diagnosis of IFD and treatment efficiency and reduce the medical burden of patients.

Key words: （1,3）-beta-D-glucosan, Invasive fungal disease, Hematological malignancy

中图分类号:

R446.5

萧晨路, 韩立中, 倪语星. 血浆（1,3）-β -D-葡聚糖检测对血液病患者侵袭性真菌病的诊断价值[J]. 检验医学, 2016, 31(8): 675-678.

XIAO Chenlu, HAN Lizhong, NI Yuxing. The detection of （1,3）-beta-D-glucosan in hematological patients with invasive fungal disease[J]. Laboratory Medicine, 2016, 31(8): 675-678.

图/表 3

参考文献 14

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组别	例数	BDG
组别	例数	阳性	阴性
确诊IFD组	2	2（100.0）	0（0.0）
临床诊断IFD组	128	100（78.1）	28（21.9）
可疑IFD组	101	19（18.8）	82（81.2）
非IFD组	168	34（20.2）	134（79.8）
合计	399	155（38.9）	244（61.2）

组别	例数	BDG
组别	例数	阳性	阴性
确诊IFD组	2	2（100.0）	0（0.0）
临床诊断IFD组	128	100（78.1）	28（21.9）
可疑IFD组	101	19（18.8）	82（81.2）
非IFD组	168	34（20.2）	134（79.8）
合计	399	155（38.9）	244（61.2）

血浆（1,3）-β -D-葡聚糖检测对血液病患者侵袭性真菌病的诊断价值

The detection of （1,3）-beta-D-glucosan in hematological patients with invasive fungal disease

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