碱处理法提高血清1,3-β-D-葡聚糖检测的特异性

Alkali treatment method for improving the specificity of serum 1,3-beta-D-glucan determination

目的了解碱处理法处理血清样本对于提高临床1,3-β-D-葡聚糖检测特异性的价值。方法收集73例浙江省某医院2013年4月—2014年12月疑似深部真菌感染患者的血清,分别采用碱处理法试剂盒和加热稀释法试剂盒检测血清1,3-β-D-葡聚糖水平,以真菌培养结果作为评价标准,采用SPSS 19.0软件进行统计分析。结果碱处理法、加热稀释法与真菌培养结果的符合率分别为87.50%、63.64%。碱处理法结果与加热稀释法比较,差异有统计学意义(P<0.05)。一致性检验结果显示,2种处理方法一致性欠佳(Kappa=0.718)。结论碱处理法使检测体系中1,3-β-D-葡聚糖以低级结构形态存在,消除了高级结构对结果的影响,从而大大提高血清1,3-β-D-葡聚糖检测的特异性,优于加热稀释法。

Objective To study alkali treatment method for improving the specificity of serum 1, 3-beta-D- glucan determination. Methods A total of 73 patients suspected with invasive fungal disease were enrolled from April 2013 to December 2014. Serum 1, 3-beta-D-glucan level was determined by alkali treatment method and heating dilution method, respectively. The results of fungal culture were as evaluation standard. The results were analyzed by SPSS 19.0 software. Results The coincidence rates of alkali treatment method and heating dilution method with fungal culture were 87.50% and 63.64%,respectively. There was statistical significance between alkali treatment method and heating dilution method （P〈0.05 ） . The consistency of the 2 treatment methods was not good （Kappa=0.718 ）. Conclusions Alkali treatment method could make 1, 3-beta-D-glucan existing with a low structure form and also eliminating the effect of high structure, which improves the specificity of serum 1 , 3-beta-D- glucan determination. So, alkali treatment method is better than heating dilution method.