G试验和GM试验联合检测在诊断侵袭性肺部真菌感染的临床应用

Clinical application of G test and GM test in the diagnosis of invasive fungal infection of the lung

目的探讨1,3-β-D葡聚糖检测(G试验)和半乳甘露聚糖抗原检测(GM试验)在侵袭性肺部真菌感染诊断中的应用价值,尤其是慢性阻塞性肺疾病(COPD)合并真菌感染的诊断。方法回顾性调查洛阳市中心医院近1年内208例确诊为侵袭性肺部真菌感染患者,此研究对象同时做G试验检测、GM试验检测、痰液真菌培养,将结果进行比较。结果 208例患者中,128例患者真菌培养阳性,酵母菌99例,曲霉菌29例。酵母菌中,白色念珠菌64例,热带念珠菌15例,克柔念珠菌11例,光滑念珠菌7例,近平滑假丝酵母菌2例。试验设定3组,第一组为G试验含量增高而GM试验正常,第二组为G试验和GM试验含量均增高,第三组为G试验含量正常组,再分别对3组内患者的真菌培养结果进行研究。结论 G试验和GM试验联合检测较真菌培养特异性高,可作为侵袭性肺部真菌感染的辅助诊断。

Objective To investigate the value of1,3-β-D glucan test(G test)and galactomannan antigen detection(GM test)in the diagnosis of invasive pulmonary fungal infection,especially chronic obstructive pulmonary disease(COPD)with fungal infection.Methods A retrospective study was carried out in208cases of invasive fungal infection in LuoyangCentral Hospital during the past1year.Subjects were examined with G test,GM test and sputum fungal culture.The threedetection results were compared.Results Of the208patients,128were positive for fungal culture,99were yeast,and29wereAspergillus.Candida albicans was found in64cases,Candida tropicalis in15cases,Candida in11cases,Candida in7cases,andCandida albicans in2cases.The experiment set3groups,the first group was the content increased in G test but normal in GMtest,the second group was content increased in both G test and GM test,the third group was content normal in G test.The resultsof fungal culture in3groups were studied.Conclusion The combination of G test and GM test is more specific than fungalculture,and can be used as an auxiliary diagnosis for invasive pulmonary fungal infection.