检测血清半乳甘露聚糖对诊断侵袭性肺曲霉菌病的临床研究

Clinical study on detection of serum effects of galacto-Mannan in diagnosis of invasive pulmonary aspergillosis

目的采用酶联免疫吸附法(即ELISA法)测定半乳甘露聚糖(GM)在血清中的浓度对诊断侵袭性肺曲霉菌病(IPA)的临床应用价值。方法应用ELISA法来检测临床上疑诊为肺曲霉菌感染的110例患者共计130份血清中的GM的浓度并且依据欧洲癌症研究治疗组织和真菌研究组(EOR TC/MSG)的诊断标准将病例进行分类,并且按照不同的阳性的判断标准来分别评价采用ELISA法检测血清中GM的浓度进而诊断IPA的临床应用价值。结果 110例病例中临床诊断者有8例,拟诊病例有18例,临床排除该病者84例。应用血清GM值>1表示判断为阳性的标准时,16例GM实验显示阳性,其中临床诊断的病例有6例,拟诊的病例有10例,灵敏度分别是75.0%(6/8),55.6%(10/18);临床排除该病的病例行GM实验,均为阴性,特异性为100%(84/84)。若以GM值>0.5表示判断为阳性的标准(也包含可疑阳性者)时,34例GM实验显示阳性,其中临床诊断的病例有6例,拟诊的病例有16例,灵敏度分别是75.0%(6/8),88.9%(16/18);临床排除该病的病例行GM实验,其中有12例为阳性,特异性为85.7%(72/84)。结论检测血清中的GM浓度可以用来早期诊断IPA,有可能成为临床上筛查IPA的主要手段。

Objective To expbre the clinical application value of use of enzyme - linked immunosorbent assay （ ELISA method） determination of galacto -Mannan -oligosaeharrides Chitosan （GM） concentrations in serum in diagnosis of in- vasive pulmonary aspergillosis （IPA）. Methods Application of ELISA method to detect clinically suspected pulmonary aspergillosis in 110 cases of GM concentration in serum of patients with a total of 130,and based on the European re- search group for research on cancer treatment organizations and fungi （EOR TC/MSG） diagnostic criteria for classifying cases, and according to different criteria to positive evaluated using serum concentrations of GM by ELISA, and then diag- nose the IPA. Results There are 8 cases in 1 l0 cases are the clinical diagnosis, 18 patients with suspected cases, exclu- ded were 84 cases of clinical disease. Application of serum GM value 〉 1 means that the criteria judged as positive, 16 eases of GM experiments have shown positive ,clinical diagnosis of cases in which there are 6 cases ,there are 10 cases of legislation intended to be medical advice. Sensitivity,respectively 75% and 55.6%. Clinical exclusion from the symptoms of the disease, routine GM experiments ,were negative. Specificity was 100% （84/84）. Application of serum GM value 〉0. 5 means that the criteria judged as positive（ Also contains the questionable positive） ,34 cases ot biVl experiments nave shown positive. Among them there are 6 cases of clinical diagnosis ,there are 16 cases of legislation intended to be medi- cal advice. The sensitivity respectively is 75.0% （6/8）, 88.9% （ 16/18 ） ;Clinical exclusion from the symptoms of the disease ,routine GM experiments, among them there are 12 cases were positive. Specificity was 85.7% （72/84）. Con- elusions Detection of serum concentration of GM in the IPA can be used to early diagnosis, may become a primary means of clinical screening on IPA