支气管肺泡灌洗液G试验GM试验对侵袭性肺部真菌感染诊断价值

Value of G Test and GM Test of Bronchoalveolar Lavage Fluid in the Early Diagnosis of Invasive Pulmonary Fungal Infection

目的分析支气管肺泡灌洗液G试验GM试验对侵袭性肺部真菌感染诊断价值。方法随机选取医院2017年1月-2020年1月来院诊断治疗IPFI的患者85例,将其纳入观察组。另外选取我院同期治疗的肺部细菌感染患者85例,作为对照组。获取患者支气管肺泡灌洗液进行G试验和GM试验。比较比较对照组和观察组患者G试验、GM试验结果,分析G试验、GM试验和联合诊断价值。结果观察组患者G试验、GM试验结果BG含量均高于对照组(P<0.05)。G试验诊断阳性结果中有79例符合病理学组织诊断阳性结果,将5例阴性病理学组织诊断结果误诊为阳性。80例符合病理学组织诊断阴性结果,将6例病理学组织诊断结果阳性诊断为阴性。灵敏度92.94%、特异度94.12%、阳性预测值94.05%、阴性预测值93.02%。GM试验诊断阳性结果中有75例符合病理学组织诊断阳性结果,将8例阴性病理学组织诊断结果误诊为阳性,77例符合病理学组织诊断阴性结果,将10例病理学组织诊断结果阳性诊断为阴性。灵敏度88.24%、特异度90.59%、阳性预测值90.36%、阴性预测值88.51%。联合诊断的曲线下面积0.96%、灵敏度92.94%、特异性98.835,高于单纯G试验、GM试验诊断(P<0.05)。结论 G试验联合GM试验可提升侵袭性肺部真菌感染诊断价值,便于早期诊断。

Objective To investigate value of G test and GM test of bronchoalveolar lavage fluid in the early diagnosis of invasive pulmonary fungal infection(IPFI).Methods 85 IPFI patients(observation group) and 85 patients with pulmonary bacterial infection(control group) in our hospital from January 2017 to January 2020 were enrolled.G test and GM test of bronchoalveolar lavage fluid were performed in both groups.The results of two groups were compared, then the value of single and combined diagnosis of G test and GM test was analyzed.Results The BG content in G test and GM test in observation group was higher than that in control group(P<0.05).Among the positive results of G test, 79 cases were consistent with pathological findings, and 5 cases were misdiagnosed.Among the negative results of G test, 80 cases were consistent with pathological findings, 6 cases were misdiagnosed.The sensitivity, specificity, positive predictive value and negative predictive value of G test were 92.94%,94.12%,94.05% and 93.02% respectively.Among the positive results of GM test, 75 cases were consistent with pathological findings, and 8 cases were misdiagnosed.Among the negative results of G test, 77 cases were consistent with pathological findings, 10 cases were misdiagnosed.The sensitivity, specificity, positive predictive value and negative predictive value of GM test were 88.24%,90.59%,90.36% and 88.51% respectively.The area under curve, sensitivity and specificity of the combined diagnosis were 0.96%,92.94% and 98.835 respectively, which were higher than those of single test(P<0.05).Conclusion G test combined with GM test can enhance the diagnostic value of invasive pulmonary fungal infection.