G实验和真菌培养在艾滋病人深部真菌感染中的联合诊断

Combined diagnosis of G-test and fungal culture in deep fungus infection for AIDS

目的：探讨血清（1-3）-β-D葡聚糖对艾滋病人深部真菌感染的早期诊断.方法：对2014年1月～2014年3月入住我院的68例疑为深部真菌感染的艾滋病人,进行血清（1-3）-β-D葡聚糖检测,并与真菌培养加以对比及结合,观察其在深部真菌感染中的诊断价值.结果：68例疑为深部真菌感染的艾滋病患者,血清（1-3）-β-D葡聚糖阳性率为91.5％,而真菌培养的阳性率仅为57.8％,血清（1-3）-β-D葡聚糖检测阳性率明显高于真菌培养（x2=0.96,P＜0.05）.血清（1-3）-β-D葡聚糖检测与真菌培养相结合,灵敏度、特异度以及阳性预测值和阴性预测值比单独血清（1-3）-β-D葡聚糖检测或真菌培养阳性率高.结论：血清（1-3）-β-D葡聚糖检测能更早、更灵敏反应深部真菌早期感染;将其与真菌培养结合,能提高深部真菌感染的诊断率.

Objective： To evaluate（1-3）-β-D glucan for early diagnosis of fungal infections in AIDS. Methods. （1-3）-β-D glucan were quantitative detected in 68 AIDS cases who suspected deep fungus infection in our hospital during Jan to Mar, 2014. Combined with fungal culture comparisons and observed value in diagnosis of fungal infections. Results： 68 AIDS case of suspected deep fungus infection, the positive rate of （1-3）-β-D glucan and fungal culture were 91.5% and 57.8%. The positive rate of（1-3）-β-D glucan was significantly higher than fungal culture（X2 =0. 96, P〈0. 05）. Compared with individual（1-3）-β-D glucan or fungal culture, the sensitivity, specificity, positive predictive value and negative predictive value are higher in（1-3）-β-D glucan combined with fungal culture. Conclusion. （1-3）-β-D glucan is much earlier and more sensitive than fungal culture in early application in deep fungus infection. Combined（1-3）-β-D glucan and fungal culture can improve the rate of diagnosis of deep fungal infection.