侵袭性肺部真菌感染病人肺泡灌洗液BG检测意义

SIGNIFICANCE OF 1-3-β-D-GLUCAN DETECTION IN BRONCHOALVEOLAR LAVAGE FLUID IN PATIENTS WITH PULMONARY INVASIVE FUNGAL INFECTIONS

目的探讨肺泡灌洗液(BALF)中1-3-β-D-葡聚糖(BG)水平对侵袭性肺真菌感染诊断及预后判断价值。方法选取确诊的侵袭性肺部真菌感染病人34例(其中死亡9例,存活25例)、肺部细菌感染病人31例、无肺部感染者25例,检测各组血清及BALF中BG浓度,并进行比较。结果侵袭性肺部真菌感染组血清及BALF中BG浓度较细菌感染组、对照组明显升高,差异有统计学意义(F=18.444、30.767,q=-6.652^-4.682,P<0.05);细菌感染组与对照组比较,差异无显著性(P>0.05)。侵袭性肺部真菌感染组BALF与血清中BG水平有相关性(r=0.473,P<0.05);死亡组病人BALF中BG浓度明显高于存活组,差异有显著性(t=11.375,P<0.05)。以34.5ng/L为折点,高于此折点病人病死率明显升高(χ~2=11.375,P<0.05)。结论 BALF中BG检测对于侵袭性肺部真菌感染具有一定的诊断意义,并对疾病预后有一定判断价值。

Objective To explore the value of 1 3-β-Dglucan （BG） detection in bronchoalveolar lavage fluid （BALF） for diagnosing pulmonary invasive fungal infections （IFI） and predicting its prognosis. Methods Thirty four patients （nine died, and 25 survived） confirmed with pulmonary IFI （IFI group）, 31 patients with pulmonary bacterial infections （BI group）, and 25 persons with no pulmonary infections （control group） were selected for this study. The levels of BG in plasma and BALF were de- tected in each group and compared. Results The levels of BG in plasma and in BALF in IFI group were higher than that in BI group and control group （F = 18.444,30.767 ;q =- 6.652- 4.682;P〈0.05）, and the difference of that between BI and control groups was not significant （P〉0.05）. In IFI group, there was a correlation between BG levels in plasma and in BALF （r=0.473, P〈0.05）. In death group, the level of BG in BALF was higher than that in the survival （t=11.375,P〈0.05）. Taking 34.5 ng/L as the break point, above this point, the mortality significantly increased （X2 = 11.375,P〈0.05）. Conclusion The detection of 1-3-β-D-glucan level in bronchoalveolar lavage fluid has a certain value in the diagnosis of pulmonary invasive fungal infections and in prediction of its prognosis.