G试验对侵袭性真菌感染新生儿早期筛查价值分析

Value of G Test in Early Screening of Invasive Pulmonary Fungal Infection in Neonates

目的:探讨G试验对侵袭性真菌感染(IPFI)新生儿早期筛查价值。方法:选取2016年1月-2019年6月本院收治的疑似IPFI新生儿260例作为真菌感染组,选取同期本院117例细菌感染新生儿作为细菌感染组,另选取本院同期健康新生儿54例作为对照组。三组均进行G试验,比较三组血清1,3-β-D葡聚糖水平。以真菌培养结果为诊断金标准,比较IPFI与非IPFI患儿的血清1,3-β-D葡聚糖水平,分析G试验在IPFI新生儿早期筛查中的价值。结果:真菌感染组血清1,3-β-D葡聚糖水平均高于细菌感染组与对照组(P<0.05)。真菌感染组中,IPFI患儿214例,非IPFI患儿46例。IPFI患儿的血清1,3-β-D葡聚糖水平高于非IPFI患儿(P<0.05)。214例IPFI患儿致病菌均为念珠菌属,其中白色假丝酵母菌与近平滑假丝酵母菌占比较高。G试验对IPFI诊断的敏感度为88.32%、准确度为88.08%、特异度为86.96%。结论:G试验在IPFI新生儿早期筛查中具有较高诊断价值,可作为临床对IPFI的早期预警指标,值得临床推广。

Objective:To explore the value of G test in early screening of invasive pulmonary fungal infection(IPFI)in neonates.Method:A total of 260 suspected IPFI neonates admitted to our hospital from January 2016 to June 2019 were selected as the fungal infection group,117 bacterial infection neonates in our hospital during the same period were selected as the bacterial infection group,and 54 healthy neonates in our hospital during the same period were selected as the control group.Serum 1,3-β-D glucan levels were compared among the three groups by G test.The serum 1,3-β-D glucan levels were compared between IPFI and non-IPFI neonates with fungal culture results as the gold standard for diagnosis,and the value of G test in early screening of IPFI neonates was analyzed.Result:The serum 1,3-β-D glucan level of the fungal infection group was higher than those of the bacterial infection group and the control group(P<0.05).In the fungal infection group,214 neonates with IPFI and 46 neonates with non-IPFI.The serum 1,3-β-D glucan level of IPFI neonates was higher than that of non-IPFI neonates(P<0.05).The pathogenic bacteria of 214 IPFI neonates were all Candida,among which Candida albicans and Candida albicans accounted for a high proportion.The sensitivity,accuracy and specificity of G test to IPFI diagnosis were 88.32%,88.08%and 86.96%.Conclusion:G test has high diagnostic value in early screening of IPFI neonates,it can be used as an early warning indicator of IPFI in clinical practice and is worthy of clinical promotion.