血清磷酸丙酮酸水合酶检测对诊断侵袭性白念珠菌感染的临床价值

Serum phosphopyruvate hydratase in diagnosis of invasive Candida albicans infection

目的通过对侵袭性白念珠菌感染时磷酸丙酮酸水合酶血清水平检测,评价磷酸丙酮酸水合酶抗原在诊断中的价值。方法选择40例患者,其中确诊、临床拟诊、浅表定植白念珠菌患者分别为18、12、10例作为实验组,同时选择健康体检人员10例作为阴性对照组,留取血标本。采用酶联免疫吸附测定(ELISA)法测定血清中磷酸丙酮酸水合酶的OD值,通过标准曲线反应出待测血清中抗原含量。结果确诊组和临床诊断组血清磷酸丙酮酸水合酶的平均浓度与后两组差异显著;用ELISA检测血清磷酸丙酮酸水合酶的浓度,以0.35μg/mL诊断阈值的敏感性、特异性分别为77%、100%。结论侵袭性白念珠菌感染时血清磷酸丙酮酸水合酶水平明显高于定植组和健康组,提示血清磷酸丙酮酸水合酶抗原检测可作为侵袭性白念珠菌感染的诊断指标,以0.35μg/mL为诊断阈值对诊断侵袭性白念珠菌感染的敏感性、特异性较为理想。

Objective To evaluate the role of phosphopyruvate hydratase in diagnosis of invasive Candida albicans infection. Methods Forty patients were divided into three experimental groups： 18 patients were confirmed with invasive Candida albicans infection, 12 patients were clinically diagnosed with invasive Candida albieans infection and 10 patients were Candida albicans superficial colonization. Another 10 persons who had undergone physical examinations served as the negative control group. Absorbanee value（ OD value）of phosphopyruvate hydratase in the serum was determined with enzyme-linked immunosorbent assay （ELISA）to establish a standard curve. The OD values of phosphopyruvate hydratase could reflect the antigen level in the serum. Results By a multiple comparison, the confirmed diagnosis group and clinical diagnosis group had significant differences compared with the other groups. Using ELISA to estimate consistency of phosphopyruvate hydratase in the serum and taking 0. 35μg/ ml as the cut-off point, the diagnostic sensitivity and specificity were 77% and 100%. Conduston Serum phosphopyruvate hydratase level was significantly higher in the invasive Candida albieans infection groups than in the colonization and healthy groups, which suggested that serum phosphopyruvate hydratase antigen could be an ideal index, and 0.35 μg/ml is the ideal threshold in sensitivity and specificity of invasive Candida albieans infection.