血浆1,3-β-D葡聚糖在早产儿真菌感染中的意义

Significance of plasma 1,3-β-D glucan in fungal infection among premature infants

目的：了解1，3-β-D葡聚糖在早产儿真菌感染诊断中的意义。方法：选用广东省第二人民医院2012年1—12月NICU住院的早产儿35例作为观察组，选用真菌药物治疗动态检测1，3-β-D葡聚糖，评价其对抗真菌药物疗效的价值。结果：观察组患者治疗前血浆中1，3-β-D葡聚糖含量为（302．1±103．5）pg／ml，对照组为（165．2±104．3）pg／ml，差异有统计学意义（t=2．21，P〈0．01）。7天治疗后含量差异无统计学意义（P〉0．05）；界值为15pg／ml时，敏感性与特异性之和最大，即诊断的误诊率与漏诊率之和最小，说明本研究结果15pg／ml为最佳阳性界值。结论：项目的研究不仅可以让深部真菌感染的患儿得到及早治疗，降低病死率，还可以节省大量医疗资源，减轻患儿未发育成熟的器官组织的负荷及患儿家长的经济负担，避免抗真菌药物的过度使用，减少耐药菌株的产生。

Objective： To understand the significance of plasma 1,3-β-D glucan in fungal infection among premature infants. Methods： Thirty -five premature infants were selected from NICU of the hospital from January to December in 2012 as observation group, 1,3-β-D gluean level was detected after antifungal treatment, and its value for curative effect of antifungal drugs was evaluated. Results： The contents of plasma 1,3-β-D glucan before treatment in observation group and control group were （ 302. 1 ± 103.5 ） pg/ml and （ 165. 2 ± 104. 3） pg/ml, respectively, there was statistically significant difference between the two groups （ t = 2. 21, P 〈 0. 01 ） ; but there was no statistically significant difference after seven days between the two groups （P 〉 0. 05 ） ; when the critical value was designed as 15 pg/ ml, the sum of sensitivity and specificity was the highest, which meant that the sum of misdiagnosis rate and rate of missed diagnosis was the lowest, so 15 pg/ml was the optimal positive critical value in the study. Conclusion： The project can not only provide early treatment for the children with deep fungal infection, reduce the mortality rate, but also can save a lot of medical resources, alleviate organ load of children and economic burden of their parents, avoid excessive use of antifungal drugs, reduce the emergence of resistant strains.