抗烯醇化酶抗体与(1-3)-β-D-葡聚糖检测诊断侵袭性念珠菌病的临床比较

Comparative diagnostic values of anti-enolase assay and the(1,3)-β-D-glucan assay in early invasive candidiasis

目的比较抗烯醇化酶抗体(抗-Eno)检测与(1-3)-β-D-葡聚糖(BG)检测对侵袭性念珠菌病(invasive candidiasis,IC)的诊断价值。方法留取临床为诊断IC而送检BG测定的患者血样,用ELISA法测定抗-Eno抗体,以真菌培养结果为基础,分析比较两种血清学方法诊断IC的效能。结果 210例患者为研究对象。15例患者经念珠菌培养确诊IC,确诊感染率7.1%;BG阳性54例,阳性率为25.7%;抗-Eno阳性33例,检出阳性率为15.7%。抗-Eno和G试验诊断IC感染的敏感性、特异性、阳性预测值、阴性预测值分别为46.7%、86.7%、21.2%、95.5%和33.3%、74.9%、9.3%、93.6%。两种血清学方法联合检测,敏感性提高至66.7%。结论抗-Eno对IC的诊断性能优于G试验;联合两种血清学方法,能有效提高敏感性。

Objective To compare the anti-enolase（anti-Eno）assay with traditional（1,3）-β-D-glucan（BG）assay for the early diagnosis of invasive candidiasis（ IC） Methods Blood samples collected from patients of suspected IC were analyzed with both anti-Eno and BG detection Diagnostic values were compared based upon the results of fungal culture Results A total of 210 patients were enrolled into this study Fifteen patients（ 7 1%）were diagnosed as definitive IC by fungal culture Positive results were obtained in 54（25 7%）and 33（15 7%）patients by BG and anti-Eno assay,respectively The sensitivity,specificity,posi-tive predictive value and negative predictive value were 46 7%,86 7%,21 2% and 95 5% in anti-Eno assay while 33 3%,74 9%,9 3% and 93 6% in（1,3）-β-D-glucan assay The sensitivity for IC diagnosis was enhanced to 66 7% upon the combination of anti-Eno and（1,3）-β-D-glucan assay Conclusion Anti-Eno assay is superior to（1,3）-β-D-glucan assay in the diagnosis of early IC Combining these two assays can improve the sensitivity of IC diagnosis.