血浆(1,3)-β-D葡聚糖检测对侵袭性肺部真菌感染的临床应用价值

Clinical diagnosis value of serum(1,3)-β-D glucan to invasive pulmonary fungal infection

目的研究血浆(1,3)-β-D葡聚糖(BG)检测对侵袭性肺部真菌感染(IPFI)在疾病的诊断、治疗监测方面的应用价值。方法收集拟诊为IPFI的患者55例,同时选取进行整形美容手术的无真菌感染的患者20例为阴性对照。应用沙保弱培养基和科玛嘉显色培养基对患者的痰液进行真菌分离培养,同时应用MB-80微生物动态快速检测系统动态检测患者血浆中BG水平。结果 55例拟诊的IPFI患者,经传统培养方法诊断23例阳性,阳性率为41.8%;经血浆BG检测35例为阳性,阳性率为63.4%,20例阴性对照组均为阴性。10例确诊IPFI患者治疗后连续检测血浆BG,8例经临床抗真菌治疗后血浆BG水平逐渐降低趋于阴性,治愈。结论血浆BG检测较传统的真菌培养分离鉴定方法简便、快速、阳性率高,是诊断IPFI的早期、有效、快速的方法。

Objective To study on the value of serum（1,3）-β-D glucan to the diagnosis and cure surveillance of invasive pulmo- nary fungal infection（IPFI）. Methods 55 IPFI patients preliminary diagnosed were collected in the hospital from September 2010 to August 2011,as well as 20 plastic surgery patients without fungal infection in the hospital were selected to be negative control. Spu- tum fungal culture was processed on Sabourand medium and CHROMagar Candida medium. （1,3）-β-D glucan was detected by MPr 80 microbiology kinetic rapid Reader. Results Using traditional culture method,23 positive cases were found in 55 IPFI patients, occupying 41.8%. 35 positive eases were detected using the serum（1, 3）-β-D glucan examination, occupying 63.4%. 20 control specimens were all negative. （1,3）-β-D glucan was continually detected in 10 cases of IPFI patients. The level of serum（ 1,3）-β-D glucan in 8 patients with IPFI gradually decreased, and the patients were cured by using effective anti-fungus treatment. Conclusion （1,3）-β-D gluean examination is simple, rapid and sensitive in diagnosis of IPFI compared with the traditional culture method. Be- cause the level of （1,3）-β-D glucan in serum can be decreased by effective anti-fungus treatment, closely surveillance of （1,3）-β-D glucan can be helpful to monitor the change of disease.