动态监测血浆1,3-β-D-葡聚糖评价早产儿真菌性败血症药物疗效的价值

Value of dynamic monitoring of plasma 1,3-β-D-glucan in evaluating efficiency of drugs for treatment of premature infants with fungal septicemia

目的探讨动态监测1,3-β-D-葡聚糖(BDG)评价早产儿真菌性败血症药物疗效的价值。方法动态监测湖南省儿童医院新生儿重症监护病房(NICU) 2018年1月—2019年12月收治的30例真菌性败血症早产儿的血浆BDG水平。结果抗真菌治疗后,治疗有效患儿28例,其血浆BDG浓度显著降低,其中8例患儿血浆BDG下降至正常水平;2例死亡患儿的血浆BDG呈进行性上升,并处于高水平状态。BDG未降至正常水平患儿的抗菌药物治疗时间长于BDG降至正常水平患儿,差异有统计学意义(P <0.05)。结论动态监测血浆BDG水平可评价所选抗真菌药物的有效性,且在评价真菌性败血症患儿预后方面也有一定的价值。

Objective To investigate the value of dynamic monitoring of 1,3-β-D-glucan( BDG) in evaluating the efficiency of drugs for treatment of premature infants with fungal septicemia. Methods Plasma levels of BDG of 30 premature infants with fungal septicemia in Neonatal Intensive Care Unit( NICU) of Hunan Provincial Children’s Hospital from January 2018 to December 2019 were dynamically monitored. Results After antifungal treatment,plasma BDG concentration in 28 cases with effective therapeutic result decreased significantly,among which 8 cases decreased to normal level;2 dead cases showed progressive increase in plasma BDG,and were in a high level. The duration of antibiotic treatment in children with BDG not decreasing to normal level was significantly longer than that in children with BDG decreasing to normal level( P < 0. 05). Conclusion Dynamic monitoring of plasma BDG level can evaluate the efficacy of selected antifungal drugs,and also has a certain value in evaluating the prognosis of children with fungal septicemia.