1,3-β-D-葡聚糖与抗白假丝酵母生殖管抗体对侵袭性假丝酵母菌病诊断价值评估

Diagnostic value of 1,3-β-D-glucan and Candida albicans germ-tube antibody for invasive candidiasis

目的评估1,3-β-D-葡聚糖和白假丝酵母生殖管抗体试验对侵袭性假丝酵母菌病的早期诊断价值。方法于PubMed、Cochrane library、知网(CNKI)、WanFang(万方)、VIP(维普)和CBM(中国生物信息学)数据库对截止2019年4月中英文文献进行检索,并对文献质量进行评价。结果共纳入6个研究,合计359例患者,1,3-β-D-葡聚糖试验:敏感性为0.75(95%CI 0.67-0.82),特异性为0.75(95%CI 0.68-0.80),阳性似然比为3.18(95%CI 1.76-5.75),阴性似然比为0.34(95%CI 0.21-0.56),SROC曲线面积AUC=0.8243;抗白假丝酵母生殖管抗体试验:敏感性为0.57(95%CI 0.48-0.65),特异性为0.78(95%CI 0.72-0.83),阳性似然比为3.07(95%CI 1.47-5.65),阴性似然比为0.59(95%CI 0.47-0.75),SROC曲线面积AUC=0.7544;联合诊断:敏感性为0.93(95%CI 0.86-0.98),特异性为0.72(95%CI 0.64-0.80),阳性似然比为3.44(95%CI 1.63-7.29),阴性似然比为0.12(95%CI 0.06-0.25),SROC曲线面积AUC=0.9283。结论1,3-β-D-葡聚糖和抗白假丝酵母生殖管抗体单独检测对侵袭性假丝酵母菌病的诊断价值无明显差异,但二者联合检测时诊断价值比抗白假丝酵母生殖管抗体单独检测高。

Objective To evaluate the diagnostic value of 1,3-β-D-glucan and Candida albicans germ tube antibody test for invasive candidiasis.Methods The relevant literatures were searched in PubMed,Cochrane library,CNKI,WanFang,CBM and VIP databases,and the quality of the literatures was evaluated.Results Six studies involving 359 patients were included.1,3-β-D-glucan:SEN=0.75(95%CI 0.67-0.82),SPE=0.75(95%CI 0.68-0.80),+LR was 3.18(95%CI 1.76-5.75),-LR was 0.34(95%CI 0.21-0.56),AUC=0.8243.Candida albicans germ-tube antibody test:SEN=0.57(95%CI 0.48-0.65),SPE=0.78(95%CI 0.72-0.83),+LR was 3.07(95%CI 1.47-5.65),-LR was 0.59(95%CI 0.47-0.75),AUC=0.7544.Joint diagnosis:SEN=0.93(95%CI 0.86-0.98),SPE=0.72(95%CI 0.64-0.80),+LR was 3.44(95%CI 1.63-7.29),-LR was 0.12(95%CI 0.06-0.25),AUC=0.9283.Conclusion There is no significant difference between the diagnostic values of 1,3-β-D-glucan and Candida albicans germ tube antibodies for invasive candidiasis,but the diagnostic value of the combination of the two detections is higher than that of Candida albicans germ tube antibody.