1,3-β-D-葡聚糖和抗白念珠菌芽管抗体检测对侵袭性念珠菌病诊断的临床价值

doi:10.3969/j.issn.1673-8640.2014.08.002

检验医学 ›› 2014, Vol. 29 ›› Issue (8): 794-797.DOI: 10.3969/j.issn.1673-8640.2014.08.002

1,3-β-D-葡聚糖和抗白念珠菌芽管抗体检测对侵袭性念珠菌病诊断的临床价值

何力志¹, 石国民², 胡方兴³

1. 湖南省第二人民医院,湖南长沙 410007;
2. 长沙市中心医院,湖南长沙 410004;
3. 长沙市第三医院,湖南长沙 410015

收稿日期:2013-10-22 出版日期:2014-08-30 发布日期:2014-09-05
作者简介:何力志,男,1973年生,学士,副主任技师,主要从事临床微生物检验工作。

Clinical significance of 1,3-beta-D-glucan and anti-Candida albicans germ tube antibody for the diagnosis of invasive candidiasis

HE Lizhi¹, SHI Guomin², HU Fangxing

1. The Second People's Hospital of Hunan Province, Hunan Changsha 410007, China;
2. Central Hospital of Changsha City, Hunan Changsha 410004, China;
3. The Third Hospital of Changsha City, Hunan Changsha 410015, China

Received:2013-10-22 Online:2014-08-30 Published:2014-09-05

摘要/Abstract

摘要： 目的探讨1,3-β-D-葡聚糖(BG)和抗白念珠菌芽管抗体(CAGTA)对侵袭性念珠菌病(IC)的诊断和治疗监测的临床价值。方法收集IC患者26例、念珠菌定植者100例。动态监测患者血浆BG和血清抗CAGTA含量,分析2项指标单用和联合应用诊断IC的敏感性、特异性、阳性预测值及阴性预测值,分析其与抗真菌治疗疗效间的关系。结果单用BG和抗CAGTA诊断IC的敏感性、特异性、阳性预测值、阴性预测值分别为61.5%、90.0%、61.5%、90.0%和57.7%、83.0%、46.9%、88.3%;BG和抗CAGTA联合检测诊断IC的特异性和阳性预测值均达100.0%,明显高于单项检测。抗真菌治疗有效组随着抗真菌治疗时间的延长,BG和抗CAGTA含量逐渐下降;治疗无效组BG和抗CAGTA含量呈持续上升趋势。结论联合监测BG和抗CAGTA不仅能提高IC诊断的特异性和阳性预测值,而且对IC的早期诊断和治疗监测具有潜在应用价值。

关键词: 抗白念珠菌芽管抗体, 1, 3-β, -D-葡聚糖, 侵袭性念珠菌病

Abstract: Objective To investigate the clinical significance to diagnose and monitor invasive candidiasis (IC) using 1,3-beta-D-glucan (BG) and anti-Candida albicans germ tube antibody (CAGTA). Methods The clinical specimens were collected from 26 patients infected IC and 100 patients colonized Candida.BG and CAGTA were detected and monitored dynamically. Sensitivity, specificity, positive and negative predictive values of the detection of BG or CAGTA and the combination detection of BG and CAGTA were analyzed. The relationship between the 2 markers and antifungal therapy was analyzed. Results The sensitivities, specificities, positive and negative predictive values of BG and CAGTA detections were 61.5%,90.0%,61.5%,90.0% and 57.7%,83.0%,46.9%,88.3%, respectively. As the combination detection of BG and CAGTA was performed, the specificity and positive predictive value, each up to 100.0%, were significantly higher than those of individual detections. The BG and CAGTA values in the effective group receiving antifungal therapy showed a gradual decline.The BG and CAGTA values varied with a upward trend in the ineffective group. Conclusions The combination detection of BG and CAGTA can improve specificity and positive predictive value for the diagnosis of IC, and it is very useful for the early diagnosis and therapeutic monitoring of IC.

Key words: Anti-Candida albicans germ tube antibody, 1,3-beta-D-glucan, Invasive candidiasis

中图分类号:

R446.62

何力志, 石国民, 胡方兴. 1,3-β-D-葡聚糖和抗白念珠菌芽管抗体检测对侵袭性念珠菌病诊断的临床价值[J]. 检验医学, 2014, 29(8): 794-797.

HE Lizhi, SHI Guomin, HU Fangxing. Clinical significance of 1,3-beta-D-glucan and anti-Candida albicans germ tube antibody for the diagnosis of invasive candidiasis[J]. , 2014, 29(8): 794-797.

参考文献

[1] S�� MB, Zaragoza R. Critical overview of clinical guidelines relating to invasive fungal infections [J]. Int J Antimicrob Agents, 2008, 32 (Supp12):S155-S159.
[2] 李真, 左绪磊. 侵袭性念珠菌病的实验室诊断研究进展[J]. 检验医学, 2007,22(1):102-104.
[3] Zaragoza R, Pem��n J, Quind��s G, et al. Clinical significance of the detection of Candida albicans germ tube-specific antibodies in critically ill patients [J]. Clin Microbiol Infect, 2009, 15(6):592-595.
[4] Ostrosky-Zeichner L, Alexander BD, Kett DH, et al. Multicenter clinical evaluation of the(1->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans [J]. Clin Infect Dis, 2005, 41(5): 654-659.
[5] 武建国. 关注侵袭性真菌感染的实验诊断[J]. 临床检验杂志, 2010, 28 (2):87-89.
[6] 钱丽洁, 朱敏, 李莉, 等. 系统性白念珠菌病患者血清中芽管抗体的检测 [J]. 中华皮肤科杂志, 2006, 39(8):460-462.
[7] Kohno S, Mitsutake K, Maesaki S, et al. An evaluation of serodiagnostic tests in patients with candidemia: beta-glucan, mannan, candida antigen by Cand-Tec and D-arabinitol [J]. Microbiol Immunol, 1993, 37(3): 207-212.
[8] Kondori N, Edebo L, Mattsby-Baltzer I. Circulating beta (1-3) glucan and immunoglobulin G subclass antibodies to Candida albicans cell wall antigens in patients with systemic candidiasis [J]. Clin Diagn Lab Immunol, 2004, 11(2): 344-350.
[9] Koo S, Bryar JM, Paqe JH, et al. Diagnostic performance of the (1→3)-beta-D-glucan assay for invasive fungal disease [J]. Clin Infect Dis, 2009, 49(11):1650-1659.
[10] Quindós G, Moragues MD, Pontón J. Is there a role for antibody testing in the diagnosis of invasive candidiasis [J]. Rev Iberoam Micol, 2004,21(1):10-14.
[11] García-Ruíz JC, del Carmen Arilla M, Regúlez P, et al. Detection of antibodies to Candida albicans germ tubes for the diagnosis and therapeutic monitoring of invasive candidiasis in patients with hematologic malignancies [J]. J Clin Microbiol, 1997, 35(12): 3284-3287.
[12] 孔小祥, 李芳秋, 王仕钦, 等. 用动物模型评估抗烯醇化酶抗体测定对系统性白念珠菌病的诊断价值 [J]. 临床检验杂志, 2011, 29(1):69-71.
[13] 孔小祥, 李芳秋, 王仕钦, 等. 抗烯醇化酶抗体检测对侵袭性念珠菌病的诊断价值[J]. 临床检验杂志, 2011, 29(6):413-415.

[1]	李梁珊, 赵虎, 王诗雯. 基于加权基因共表达网络分析筛选结直肠癌潜在的预后生物标志物[J]. 检验医学, 2023, 38(9): 825-832.
[2]	杨玉强, 全晓丽, 王刘玉, 鲜文峰, 杨红. 骨肉瘤组织RRBP1表达及其对细胞生物学特征的影响[J]. 检验医学, 2023, 38(9): 842-848.
[3]	赵沱, 白鹏飞, 孙婧, 程涛. 血清lncRNA NEAT1在急性心肌梗死患者中的表达及其临床意义[J]. 检验医学, 2023, 38(9): 897-900.
[4]	贺龙, 王莎, 程利萍, 廖子蔚, 王东红. 血清AChE、IL-17与单纯疱疹病毒性脑炎患者认知功能障碍的相关性[J]. 检验医学, 2023, 38(8): 719-724.
[5]	赵静, 李永勤, 李艳, 范伟光, 杨学刚. HIV/AIDS合并机会性感染患者IP-10、SAA、hs-CRP、PCT、CD4⁺ T细胞计数检测的意义[J]. 检验医学, 2023, 38(8): 725-729.
[6]	丁肖媛, 戴劲盛, 焦荣红, 马素丽, 朱海峰, 吴梦雅, 车艳然, 张蕾. 肥胖/超重对哮喘发作期患儿Th1/Th2和Th17/Treg细胞因子的影响[J]. 检验医学, 2023, 38(8): 748-752.
[7]	方文东, 王友亮, 陈水平. G试验影响因素分析[J]. 检验医学, 2023, 38(8): 796-799.
[8]	陈颖, 李伟, 林涛, 杨丽. PFTK1表达与非小细胞肺癌微血管密度和患者预后的关系[J]. 检验医学, 2023, 38(7): 634-639.
[9]	张旭明, 尹伟明, 高婧. 深圳市宝安地区妊娠期甲状腺功能减退患者UGT1A1基因多态性与妊娠期合并症和不良妊娠结局的关系[J]. 检验医学, 2023, 38(7): 665-668.
[10]	张莹, 景丽娟, 李丽. HBV携带者外周血单个核细胞miR-138表达与病毒增殖的关系[J]. 检验医学, 2023, 38(6): 559-562.
[11]	苏曦, 周琰, 黄剑, 高姚怡, 李懿皞, 王蓓丽, 潘柏申, 郭玮. CYP3A4 *1G多态性对行腹腔镜结肠癌根治术患者芬太尼剂量的影响[J]. 检验医学, 2023, 38(5): 419-423.
[12]	江梦颖, 刘鷖雯, 何怡青, 许静, 杨翠霞, 高锋, 杜艳. 血清S1P检测在结直肠癌早期诊断中的临床价值[J]. 检验医学, 2023, 38(4): 307-312.
[13]	张国良, 刘鷖雯, 何怡青, 许静, 杨翠霞, 高锋, 刘华. 血清HYAL1、HA在结直肠癌辅助诊断和疗效监测中的价值[J]. 检验医学, 2023, 38(4): 313-319.
[14]	刘俊闪, 郭明发, 孙佳, 史利欢, 刘炜, 段勇涛. 微量残留病监测在ETV6/RUNX1阴性和阳性急性B淋巴细胞白血病患儿预后中的意义[J]. 检验医学, 2023, 38(3): 209-214.
[15]	张银龙, 杨红. 骨肉瘤组织长链非编码RNA ZFAS1的表达及其临床意义[J]. 检验医学, 2023, 38(3): 240-244.

1,3-β-D-葡聚糖和抗白念珠菌芽管抗体检测对侵袭性念珠菌病诊断的临床价值

Clinical significance of 1,3-beta-D-glucan and anti-Candida albicans germ tube antibody for the diagnosis of invasive candidiasis

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics