痰真菌培养联合G试验与GM试验对侵袭性真菌感染诊断价值

Value of sputum culture combined with G test and GM test in diagnosis of invasive fungal infection

目的探究痰真菌培养联合(1,3)-β-D-葡聚糖检测(G试验)、半乳甘露聚糖检测(GM试验)对侵袭性真菌感染的早期诊断价值。方法选取2015年4月-2017年12月郑州大学附属郑州中心医院收治的疑诊侵袭性真菌感染的患者305例,根据侵袭性真菌感染的确诊标准将患者分为感染组及未感染组,分析痰真菌培养、G试验、GM试验检测结果,观察探讨三者联合检测对侵袭性真菌感染的早期诊断价值。结果在所有患者中,共发现113例侵袭性真菌感染患者,占37.05%。痰真菌培养、G试验、GM试验、三者联合检测的灵敏度分别为60.18%、82.30%、69.91%、97.34%,而特异度分别为82.81%、85.42%、89.06%、89.58%。G试验的灵敏度明显高于痰真菌培养试验,而三者联合检测的灵敏度均高于三者独立检测,具有统计学意义(P<0.05)。三者联合检测的特异度均高于三者独立检测,但三种方法两两比较,差异均无统计学意义。结论痰真菌培养联合G试验、GM试验能够提高诊断侵袭性真菌感染灵敏度,且特异度较好,有助于临床医师对侵袭性真菌感染的早期诊断,具有良好的应用价值。

OBJECTIVE To explore the value of sputum culture combined with(1,3)-β-D-glucan test(G test),galactomannan test(GM test)in early diagnosis of invasive fungal infection.METHODS A total of 305 patients with suspected invasive fungal infection who were treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from Apr 2015 to Dec 2017 were enrolled in the study and divided into the infection group and the non-infection group according to the criteria for diagnosis of invasive fungal infection.The results of sputum culture,G test and GM test were analyzed,and the value of the joint detection of the three tests in early diagnosis of invasive fungal infection was observed.RESULTS Of all the patients,113 had invasive fungal infection,accounting for 37.05%.The sensitivity of the sputum culture was 60.18%,the G test 82.30%,the GM test 69.91%,and the joint detection 97.34%.The specificity of the sputum culture was 82.81%,the G test 85.42%,the GM test 89.06%,and the joint detection 89.58%.The sensitivity of the G test was significantly higher than that of the sputum culture,the sensitivity of the joint detection of the three tests was significantly higher than that of the single detection,and there was significant difference(P<0.05).The specificity of the joint detection of the three test was higher than that of the single detection,however,there was no difference among the three tests.CONCLUSION The sputum culture combined with G test and GM test may raise the sensitivity of diagnosis of invasive fungal infection and facilitate the early diagnosis of invasive fungal infection,with the specificity high,and it has favorable application value.