真菌特异性抗原联合检测对侵袭性曲霉感染的早期诊断价值

Clinical Value of Combined Detection of Fungal Specific Antigen for Diagnosis of Invasive Aspergillosis

目的评价半乳甘露聚糖抗原（GM）和（1，3）-β-D-葡聚糖（BG）的检测及其联合检测对血液病和恶性肿瘤患者侵袭性曲霉感染（IA）的早期诊断价值。方法回顾192例血液病和恶性肿瘤患者血浆砧和血清GM水平，分析BG检测和GM检测及其联合检测对侵袭性曲霉感染的敏感度、特异度、阳性预测值（PPV）、阴性预测值（NPV）。结果BG和GM联合检测对IA诊断的敏感度为86．4％，特异度为98．5％，阳性预测值为97．4％，阴性预测值为91．6％。结论GM和BG联合检测对于血液病和恶性肿瘤患者侵袭性曲霉感染提高了敏感度和特异度，同时联合检测对IA的早期诊断有较高的临床意义。

Objective To estimate the early diagnosis values of （1,3）-β-D-glucan（BG） combine with galactomannan（GM） determination in Invasive Aspergillosis infeetion（IA） in patients with leukemia and malignant tumour. Methods Blood samples were obtained from 192 patients with leukemia and malignant turnout. BG and GM were detected by Microbiology Kinetic Rapid Reader MB-80 and enzyme linked immunosorbent assay. Results In the studies of profoundly leukemia and malignant turnout patients on early diagnostic,the BG combine with GM determination shown sensitlvity, specificity, positive predictive value（PPV） ,negative predictive value（NPV） were 86.4 %,98.5 %,97.4% and 91.6 % ,respectively. Conclusion Detection of BG combine with GM for patients with leukemia and malignant tumour have shown high sensitivity and specificity,and it could be a more reliable method for early diagnosis of IA.