IgG抗体检测诊断慢性肺曲霉菌病的临床价值分析

Clinical value analysis of IgG antibody detection in diagnosis of chronic pulmonary aspergillosis

目的:探讨曲霉特异性免疫球蛋白G(IgG)抗体检测诊断慢性肺曲霉菌病的临床参考价值。方法:选取2018年4月至2019年4月就诊于北京大学第三医院并疑似诊断为慢性肺曲霉菌病患者47例。收集患者的血清,分别进行1,3-β-D葡聚糖试验(G试验)、半乳甘露聚糖试验(GM试验)、曲霉特异性IgG检测,评估3种检测方法的检验效果。结果:根据临床分级诊断标准,在47例患者中曲霉菌病组有26例,非曲霉菌病组有21例。曲霉菌病组患者血清G试验检测数值为36(10,160) ng/L,GM试验检测数值为0.23(0.15,0.30),曲霉特异性IgG检测数值为151.43(84.61,322.63) AU/ml。非曲霉菌病组血清G试验检测数值为10(10,45) ng/L,GM试验检测数值为0.26(0.15,0.54),曲霉特异性IgG检测数值为57.90(42.79,137.42) AU/ml。其中经曲霉特异性IgG检测的敏感度为65.4%,受试者工作特征曲线下面积为0.785 3。结论:在慢性肺曲霉菌病患者的临床诊治中,曲霉特异性IgG抗体检测对曲霉菌的检出率较高,能够弥补GM检测的缺陷,有利于早期确诊并及时采取有效治疗措施。

Objective To evaluate the clinical value of aspergillus-specific immunoglobulin G(IgG)antibody in diagnosis of chronic pulmonary aspergillosis.Methods 47 patients who were admitted to Peking University Third Hospital from April 2018 to April 2019 and suspected to have chronic pulmonary aspergillosis infection were studied.The serum 1,3-β-glucan test(G test),galactomannan(GM)test and aspergillus-specific IgG test were performed on these patients to evaluate the results of the three test methods.Results According to the clinical classification criteria,there were 26 patients in aspergillosis group,21 patients in the non-aspergillosis group.The result of serum G test was 36(10,160)ng/L,GM test was 0.23(0.15,0.30)and aspergillus-specific IgG detection was 151.43(84.61,322.63)AU/ml in aspergillosis group.In non-aspergillosis group,the result of serum G test was 10(10,45)ng/L,GM test was 0.26(0.15,0.54)and aspergillus-specific IgG detection was 57.90(42.79,137.42)AU/ml.The sensitivity of aspergillus-specific IgG detection was 65.4%.The area under receiver operator characteristic curve of aspergillus-specific IgG detection method was 0.7853.Conclusions In the clinical diagnosis and treatment of patients with chronic pulmonary aspergillosis,aspergillus-specific IgG antibody detection has a higher detection rate for aspergillus,which can make up for the defects of GM detection,and is beneficial for early diagnosis and timely effective treatment.