G试验在深部真菌感染快速诊断中的临床价值探讨

Clinical value of G test in rapid diagnosis of deep fungal infection

目的通过分析血浆(1,3)-β-D葡聚糖(G试验)、真菌培养结果与真菌感染的相关性,探讨G试验在深部真菌感染(DFI)快速诊断中的临床价值。方法选择2013年9月-2016年1月,861例疑诊为DFI的患者进行G试验及真菌培养,分析G试验与真菌培养对DFI的诊断效率。结果在疑诊为DFI 861例患者中,临床诊断为DFI组181例,非DFI组680例。G试验与真菌培养阳性率分别为29.27%(252/861)和21.37%(184/861),两者比较,差异有统计学意义(P<0.05)。G试验诊断DFI的敏感性、特异性、阳性预测值、阴性预测值及准确度分别为89.50%、86.76%、64.29%、96.88%和87.34%;真菌培养诊断DFI的敏感性、特异性、阳性预测值、阴性预测值及准确度分别为59.12%、88.68%、58.15%、89.07%和82.46%。结论 G试验在快速、早期诊断DFI中有重要临床价值。

Objective To analyze the correlations of plasma(1, 3)-beta-D glucan(G test) and fungal culture results with fungal infection, and explore the clinical value of G test in rapid diagnosis of deep fungal infection(DFI). Methods From September 2013 to January 2016, 861 cases of patients were suspected as DFI. They underwent G trials and fungal culture. The efficiency of G test and fungal culture in diagnosis of DFI was analyzed.Results In the 861 patients suspected as DFI, 181 cases were clinically diagnosed with DFI, 680 cases were nonDFI. The positive rates of G test and fungal culture were 29.27%(252/861) and 21.37%(184/861), the difference was statistically significant(P < 0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of G test in diagnosis of DFI were 89.50%, 86.76%, 64.29%, 96.88% and 87.34% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of fungal culture in diagnosis of DFI were 59.12%, 88.68%, 58.15%, 89.07% and 82.46% respectively. Conclusions G test has important clinical value in fast and early diagnosis of DFI.