肺泡灌洗液中半乳甘露聚糖抗原检查在诊断肺部真菌感染中的应用

Application of galactomannan antigen test in bronchoalveolar lavage fluid in diagnosis of pulmonary fungal infection

目的:观察肺泡灌洗液(BALF)中半乳甘露聚糖抗原检查(GM试验)在诊断肺部真菌感染中的应用和价值。方法:选取92例肺部感染患者行支气管镜下肺泡灌洗,收集BALF行GM试验,并同时做外周血清GM试验和痰真菌培养。结果:发现BALF中的GM试验(阳性结果:检测值> 1)与肺部真菌感染的危险因素之间无差异(P>0. 05);与CT影像学(多发结节、多发浸润)、发热之间无差异(P> 0. 05)。BALF中GM试验与痰真菌培养结果有显著关联(P <0. 05),而血清中GM试验与痰真菌培养阳性结果无关联(P> 0. 05)。根据BALF中GM试验阳性结果选择肺部感染的抗真菌治疗,发现64. 2%患者抗真菌治疗有效。结论:BALF中GM试验检测结果可作为临床上肺部真菌感染一个较好的辅助诊断依据。

Objective: To observe the applied value of galactomannan antigen(GM) test in bronchoalveolar lavage fluid(BALF) in pulmonary fungal infection. Methods: Ninety-two patients with pulmonary infection were selected for bronchoscopic alveolar lavage,BALF was collected for GM test,and peripheral blood GM test and sputum fungal culture were performed simultaneously. Results: There was no significant correlation between GM test in BALF(positive result: detection value > 1) and risk factors of pulmonary fungal infection(P > 0. 05),and between GM test with CT imaging(multiple nodules,multiple infiltration) and fever(P > 0. 05). GM test in BALF was significantly correlated with sputum fungal culture(P < 0. 05),while GM test in serum was not correlated with sputum fungal culture(P > 0. 05). According to the positive results of GM test in BALF,64. 2% of patients with pulmonary infection were treated with antifungal therapy. Conclusion:GM test in BALF can provide a good auxiliary diagnostic basis for clinical pulmonary fungal infection.