血清半乳甘露聚糖检测肝病患者侵袭性真菌感染的诊断研究

Effect of serum galactomannan detection on the diagnosis of invasive fungal infections in patients with liver diseases

目的评价血清半乳甘露聚糖(galactomannan,GM)浓度测定对侵袭性真菌感染(invasive fungal infections,IFI)早期诊断的灵敏度、特异度和准确度。方法选取我院494例有IFI高危因素肝病患者的血清678份,采用双抗体夹心酶联免疫吸附法测定其GM浓度,并与传统的培养方法进行比较。结果 494例中28例曲霉菌培养阳性,按GM的吸光度指数(absorbent index,AI)为0.5,其灵敏度、特异度和准确度分别为57.14%、90.88%、89.24%;按AI为1.0,分别为42.86%、93.84%、91.63%;按AI为1.5,分别为39.29%、97.86%、95.28%。结论按AI为0.5时诊断曲霉菌感染的灵敏度最好(57.14%),特异度和准确度较好,可作为曲霉菌感染早期诊断的判断依据。

Objective To evaluate the sensitivity, specificity and accuracy of serum galactomannan （GM） concentration deter- mination in early diagnosis of invasive fungal infections （IFI）. Methods Totally 678 serum samples of 494 patients with liver diseases having risk factors for IFI were collected. GM concentration was determined using the double antibody sandwich enzyme- linked immunosorbent assay, and the results were compared with traditional method of fungal cultures. Results Among 494 patients, Aspergillus cultures were positive in 28 patients. The sensitivity, specificity and accuracy were 57.14%, 90.88% and 89.24% when the value of absorbency index （AI） of GM was 0.5, were 42.86%, 93.84% and 91.63% when the value of AI was 1.0, and were 39.29%, 97.86% and 95.28% when the value of AI was 1.5. Conclusions When the value of AI is 0.5, GM concentration deter- mination has the best sensitivity （57.14%） for diagnosing Aspergillus infection, with better specificity and accuracy, which can serve as an evidence for early diagnosis of Aspergillus infection.