血浆1-3-β-D葡聚糖检测在真菌性鼻窦炎诊断中的临床价值

Diagnostic value of plasma 1-3-β-D glucan assay in fungal rhinosinusitis

目的探讨血浆1-3-β-D葡聚糖检测在真菌性鼻窦炎中的临床诊断价值。方法回顾性分析因鼻部疾病在我院接受手术治疗的87例患者的临床资料,以病理诊断结果为依据分为两组:实验组41例(真菌性鼻窦炎组)和对照组46例(非真菌性鼻窦炎组)。分别检测两组患者手术前后血浆1-3-β-D葡聚糖的变化,以评估血浆1-3-β-D葡聚糖含量在真菌性鼻窦炎的敏感性及特异性。结果实验组术前血浆1-3-β-D葡聚糖平均值显著高于对照组(18.3±3.2 vs 2.5±3.4)pg/ml,差异具有统计学意义(t=22.24,P<0.05);实验组术后血浆1-3-β-D葡聚糖平均值显著低于实验组术前平均值(2.8±2.6 vs 18.3±3.2)pg/ml,差异具有统计学意义(t=24.07,P<0.05);血浆1-3-β-D葡聚糖检测诊断真菌性鼻窦炎的敏感性为95.1%,特异性为84.8%。结论血浆1-3-β-D葡聚糖检测诊断真菌性鼻窦炎具有快速、可靠等优点,有较高的敏感性。血浆1-3-β-D葡聚糖亦可用于监测治疗效果。该检测方法值得临床推广。

Objective To determine the clinical value of plasma 1-3 -β-D glucan assay for diagnosis of fungal rhinosinusitis. Methods Clinical data of 87 patients underwent surgical treatment for nasal diseases in our department was analyzed retrospectively. According to the postoperative pathological results, all the patients were divided into two groups, experimental group （ fuugal rhinosinusitis group, n = 41 ） and control group （ n = 46 ）. The plasma levels of 1-3-β-D glucan in all the patients of both groups were detected and compared. The specificity and sensitivity of plasma 1-3-β-D glucan assay for the diagnosis of fungal rhinosinusitis were calculated. Results The average preoperative plasma level of 1-3-β-D glucan in the experimental group （ 18.3 ±3.2 pg/ml ） was higher than that of the control group （2.5± 3.4 pg/ml） with statistically significant difference （t = 22.24,P 〈 0.05）. In the experimental group, the postoperative plasma level of 1-3 -β-D glucan （ 2.8 ±2.6 pg/ml ） was significantly lower than the preoperative level （ 18.3 ±3.2 pg/ml） with statistically significant difference （ t = 24.07, P 〈 0.05 ）. For the diagnosis of fungal rhinosinusitis via detection of plasma 1-3-β-D glucan, the sensitivity was 95. 1% and specificity was 84.8%. Conclusions Plasma 1-3-β-D glucan assay for diagnosis of fungal rhinosinusitis is reliable and convenient with high sensitivity. Meanwhile, this assay can be used for monitoring the surgical efficacy. Therefore, the detection of plasma 1-3-β-D glucan is worthy of being widely applied to clinical medicine.