658例血清半乳甘露聚糖试验检测结果分析

Analysis of 658 cases of GM test results

目的探讨血清半乳甘露聚糖(GM)试验在侵袭性曲霉菌病(IA)诊断中的应用价值。方法选取658例具有IA高危因素患者血清标本进行GM试验,同时进行痰液、支气管肺泡灌洗液、胸水、腹水标本的直接涂片镜检和真菌培养,分析评价GM试验对IA的诊断价值。结果 GM试验阳性162例,阳性率为24.62%。IA患者主要见于ICU和呼吸内科,分别占39.77%和35.22%;IA病种分布,以呼吸道感染者居多,共122例,占69.32%,其中肺部感染占45.46%,慢性阻塞性肺病占23.86%。真菌培养结果显示,烟曲霉菌占首位,为89.13%。GM试验的灵敏度、阴性预测值高于直接涂片镜检和真菌培养2种方法,而其特异度和阳性预测值则低于直接涂片镜检和真菌培养2种方法。结论 GM试验对诊断IA具有重要的参考价值。

Objective To investigate the application value of serum galactomannan test（GM） in the diagnosis of invasive aspergillosis（IA）.Methods 658 cases of serum samples with high risk factors in patients with IA were conducted for GM test,and the direct smear microscopy and fungal culture of sputum and bronchoalveolar lavage fluid,chest water specimens were performed simultaneously.To analyze and evaluate the value of GM test in the diagnosis of IA.Results 162 cases were conducted for positive GM test,and the positive rate was 24.62%.IA patients were mainly found in ICU and respiratory medicine,accounting for 39.77% and 35.22% respectively;IA disease distribution concentrated in respiratory tract infections（122）,accounting for 69.32%,including pulmonary infection（45.46%）,chronic obstructive pulmonary disease（23.86%）.Aspergillus fungus culture results showed that Aspergillus fumigatus occupied the first place,accounting for 89.13%.GM test sensitivity,negative predictive value were higher than direct smear microscopy and fungal culture,and its specific degree and positive predictive value is lower than the two methods.Conclusion GM test has an important reference value in the diagnosis of IA.