GM试验联合肺部CT检查对肺部真菌感染的诊断价值

Diagnostic value of GM test combined with pulmonary CT examination for pulmonary fungal infection

目的探讨半乳甘露聚糖抗原检测(GM试验)联合肺部CT检查对肺部真菌感染的诊断价值。方法选择2017年6月至2019年6月该院收治的疑似肺部真菌感染患者63例作为研究对象。所有患者均采集血清及肺泡灌洗液行GM试验,并进行肺部CT检查。分析患者菌种分布情况;比较血清与肺泡灌洗液GM试验的诊断价值;分析肺部CT检查的典型表现;评价肺泡灌洗液GM试验与肺部CT检查的联合诊断价值。结果肺泡灌洗液GM试验诊断肺部真菌感染的符合率(85.71%)高于血清GM试验(79.37%),差异有统计学意义(P<0.05)。肺泡灌洗液GM试验联合肺部CT检查诊断肺部真菌感染的灵敏度为88.00%,特异度为97.37%,阳性预测值为95.65%,阴性预测值为92.50%,诊断符合率为93.65%。肺泡灌洗液GM试验联合肺部CT检查诊断肺部真菌感染的符合率高于肺部CT检查及肺泡灌洗液GM试验单独诊断,差异有统计学意义(P<0.05)。结论肺泡灌洗液GM试验联合肺部CT检查可提高肺部真菌感染的诊断准确性,具有较高的临床应用价值。

Objective To explore the diagnostic value of galactomannan antigen detection(GM test)combined with pulmonary CT examination for pulmonary fungal infection.Methods A total of 63 patients with suspected pulmonary fungal infection admitted to the hospital from June 2017 to June 2019 were selected as the research objects.All patients were collected serum and alveolar lavage fluid for GM test and performed pulmonary CT examination.The distribution of bacteria in patients was analyzed.The diagnostic value of serum and alveolar lavage fluid GM test were compared.The typical performance of pulmonary CT examination was analyzed.Evaluated the combined diagnostic value of alveolar lavage fluid GM test and pulmonary CT examination.Results The coincidence rate of the alveolar lavage fluid GM test in the diagnosis of pulmonary fungal infection(85.71%)was higher than that of the serum GM test(79.37%),and the difference was statistically significant(P<0.05).The sensitivity of alveolar lavage fluid GM test combined with pulmonary CT examination to diagnose pulmonary fungal infection was 88.00%,specificity was 97.37%,positive predictive value was 95.65%,negative predictive value was 92.50%,and the diagnostic coincidence rate was 93.65%.The coincidence rate of alveolar lavage fluid GM test combined with pulmonary CT examination to diagnose pulmonary fungal infection was higher than that of pulmonary CT examination and alveolar lavage fluid GM test alone,the difference was statistically significant(P<0.05).Conclusion Alveolar lavage fluid GM test combined with pulmonary CT examination can improve the diagnostic accuracy of pulmonary fungal infection,and has high clinical application value.