血清GM检测对慢阻肺患者侵袭性肺曲霉感染的诊断价值

Value of Serum GM Test for the Diagnosis of Invasive Pulmonary Aspergillosis in Patients with Chronic Obstructive Pulmonary Disease

目的探讨血清半乳甘露聚糖检测(简称GM检测)对慢性阻塞性肺疾病患者(COPD)并发侵袭性肺曲霉感染(IPA)的诊断价值。方法 51例慢性阻塞性肺疾病患者纳入本研究。按回顾性诊断标准分为确诊IPA 8例,可疑IPA 12例,排除IPA 31例。采用双夹心酶联免疫吸附法检测血清或其他体液标本的GM含量,结果以GM吸光度值判断,对确诊组中的3例患者在治疗后复查GM。结果确诊IPA组和可疑IPA组的血清GM吸光度值明显高于排除IPA组。将0.7作为阳性界定值时,其敏感性、特异性、阳性预测值、阴性预测值均较高,分别为87.5%、96.6%、87.5%、96.6%。结论血清GM检测对慢性阻塞性肺疾病患者侵袭性肺曲霉感染具有一定的早期诊断价值。

Objective To explore the value of serum galaetomannan（GM） test for the diagnosis of invasive pulmonary aspergillosis （IPA） in patients with chronic obstructive pulmonary disease （COPD）. Methods Totally 51 patients with COPD were included in the study. All patients were divided into 8 patients of proven diagnosis, 12 of suspicious diagnosis,31 of excluded diagnosis according to the retrospective diagnostic criteria. ELISA method was used to detect GM of the serum or other body fluids samples. Results The serum GM optical density index（ODI） of patients of proven diagnosis and suspicious diagnosis groups was significantly different from that of excluded diagnosis. If the cut- off was set at 0. 7, the sensitivity, specificity, positive predict value, negative predict value were 87.5% ,96.6% , 87.5% ,96.6% ,respectively. Conclusion Serum GM detection has certain early diagnostic value for IPA patients with COPD.