G试验联合GM试验在恶性血液病侵袭性真菌感染的诊断价值

The diagnostic value of G/GM test for invasive fungal infections in hematological malignant patients

目的:探讨血浆1,3-β-D葡聚糖检测(G实验)联合曲霉半乳甘露聚糖检测(GM试验)对恶性血液病侵袭性真菌感染(IFI)的诊断价值。方法:应用MB-80微生物动态快速检测系统和酶联免疫吸附法定量检测血浆1,3-β-D葡聚糖及半乳甘露聚糖的含量,将检测结果及临床特征进行分析。按照欧洲癌症研究治疗组织及真菌研究组(EORTC/MSG)诊断标准,在349例患者中,确定诊断2例,临床诊断23例,临床拟诊175例,排除诊断149例。结果:G、GM试验分别以20ng/ml、0.5为诊断界值,G试验的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为77%、89.9%、91.1%、74.4%。G/GM试验的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为100%、90.4%、85.9%、100%。结论:G试验联合GM试验是诊断恶性血液病患者IFI的早期、快速的方法。

Objective：To explore the diagnostic value of plasma G（1,3-β-D glucan） /GM（galactomannan） combined detection in diagnosis of invasive fungal infections（IFI） in hematological malignancies patients.Methods：The concentration of plasma 1,3-β-D glucan and galactomannan was detected by MB-80 Microbiology Kinetic Rapid Detection System and ELISA.There were 2 patients diagnosed as proven IFI,23 as probable IFI,175 as possible IFI and 149 as no IFI.Results：G and GM test at a cutoff of 20pg/ml and 0.5 respectively,the sensitivity and specificity of G test were 77% and 89.9%,with a positive predictive value（PPV） of 91.1% and a negative predictive value（NPV） of 74.4%.The sensitivity and specificity of G/GM test were 100% and 90.4% respectively,with a positive predictive value（PPV） of 85.9% and a negative predictive value（NPV） of 100%.Conclusion：G/GM test is an early and rapid method for diagnosis of IFI in hematological malignancies patients.