(1,3)-β-D-葡聚糖连续监测在抗真菌药物治疗中的评价

Evaluation of continuous monitoring of (1,3)-β-D-glucan in antifungal therapy

目的通过连续监测血清(1,3)-β-D-葡聚糖,比较其在抗真菌药物治疗与非治疗患者的变化,分析其在抗真菌药物治疗中的意义,以期为临床治疗提供参考依据。方法选取2013年7月-2014年10月医院118例连续监测G试验阳性患者(2周内至少检测3次),根据是否抗真菌治疗分为治疗组86例与非治疗组32例,比较两组患者间血清(1,3)-β-D-葡聚糖的变化及转阴率;采用SPSS20.0软件进行统计分析。结果治疗组血清(1,3)-β-D-葡聚糖的含量下降较明显(P<0.05),由首次的(2.664±0.607)pg/ml降至第14天的(2.395±0.524)pg/ml;而非治疗组血清(1,3)-β-D-葡聚糖变化不明显;治疗组的G试验转阴率为27.91%,高于非治疗组的15.60%。结论 (1,3)-β-D-葡聚糖检测不仅可用于侵袭性真菌病的辅助诊断,动态监测更可成为临床治疗效果的依据,亦可用于观察判断患者的病情。

OBJECTIVE To monitor and compare the concentration of serum（1,3）-β-D-glucan in the patients with and without antifungal therapy and analyze the significance in the antifungal therapy so as to provide guidance for the clinical treatment.METHODS A total of 118 patients who were positive for the G test in continuous monitoring（for at least 3times within 2weeks）from Jul 2013 to Oct 2014 were enrolled in the study and divided into the treatment group with 86 cases and the non-treatment group with 32 cases according to the status of antifungal therapy.The change of serum（1,3）-β-D- glucan and the negative rate were observed and compared between the two groups of patients,and the statistical analysis was performed with the use of SPSS20.0software.RESULTS The serum（1,3）-β-D-glucan concentration of the treatment group was significantly decreased（P〈0.05）,dropping from（2.664±0.607）pg/ml on Day 1to（2.395±0.524）pg/ml on Day 14;while the serum（1,3）-β-D-glucan concentration of the non-treatment group did not change remarkably.The negative rate of G test of the treatment group was 27.91%,higher than 15.60% of the non-treatment group.CONCLUSIONThe serum（1,3）-β-Dglucan concentration can be used for the auxiliary diagnosis of invasive fungal diseases,and the dynamic monitoring of the serum（1,3）-β-D- glucan concentration can be used for the evaluation of clinical therapeutic effect as well as for the judgment of illness condition.