侵袭性真菌感染诊断进展

Advancement in the diagnosis of invasive fungal infection

侵袭性真菌感染的诊断问题是影响治疗和预后的重要环节。临床实践中组织病理诊断仍是诊断的金标准,但组织病理诊断十分困难,常规检查方法培养和分泌物直接镜检阳性率低,污染和致病很难区分;影像学表现虽然没有特征性但具有重要的提示价值,特别是动态观察更有价值。真菌抗原成分的检测是有前途的辅助诊断手段,但敏感性和特异性仍需改进。在侵袭性真菌感染诊断中必须结合临床特征、影像资料和实验室检查及治疗后的动态观察综合判断。

The acurate diagnosis of invasive fungal infection（IFI） is the key point for the treatment and proginosis for IFI patients. Pathological diagnosis is still considered as the gold standard for the IFI diagnosis although difficult. The regular procedures for IFI diagnosis including culture and direct examintion are often low yeilding, the discrimination for contamination and infection is hard. Imaging manifestations are nonspecific but have important suggestive values. The detection for molds antigen content is useful,but its sensitivity and specifity need to be improved. The proper diagnosis for IFI relys on the combination of clinical characteristic,imaging manifestion and serial observation.