聚合酶链反应诊断侵袭性肺曲霉病的研究进展

Recent advances about polymerase chain reaction for diagnosing invasive pulmonary Aspergillosis

侵袭性肺曲霉病（IPA）常见于血液系统疾病、中性粒细胞缺乏患者，病死率高。近年来发现非中性粒细胞缺乏宿主并发IPA增多，早期诊断困难。指南推荐半乳甘露聚糖试验对免疫缺陷宿主并发IPA具有较高的敏感度，可作为微生物诊断标准之一，但其对非粒细胞缺乏宿主并发IPA的敏感度较低。聚合酶链反应敏感度高且快速稳定，有望成为诊断IPA的有效方法之一。现就近年来聚合酶链反应诊断IPA的研究进展进行综述。

Invasive pulmonary Aspergillosis （IPA） is common in patients with neutropenia and hematological diseases. Nonneutropenic patients with IPA increased in recent years. Early diagnosis of IPA is notoriously difficult, and few diagnostic tools are available. The guidelines recommended serum and bronchoalveolar lavage fluid （BALF） galactomannan （GM） as an accurate marker for the diagnosis of IPA in adults and pediatric patients when used in certain patient subpopulations （hematologic malignancy, hematopoietic stem cell transplantation）, but their sensitivity to IPA with normal immune function is lower. Polymerase chain reation （PCR） is more sensitive, rapid and stabilized than GM, which is expected to be one of the effective methods to diagnose invasive pulmonary Aspergillosis. This review focuses on the recent advances about PCR-based assay for early diagnosing invasive pulmonary Aspergillosis.