慢性阻塞性肺疾病急性加重期患者应用痰真菌涂片与痰真菌免疫荧光染色检测法进行快速诊断的价值比较

Comparison of rapid diagnosis value between sputum fungal smear and sputum fungal immunofluorescence staining in patients with acute exacerbation of chronic obstructive pulmonary disease

目的比较痰真菌涂片与痰真菌免疫荧光染色检测法用于慢性阻塞性肺疾病急性加重期(AECOPD)患者的快速诊断的价值。方法选取2019年6月—2020年6月于上海市东方医院吉安医院送检的60例AECOPD患者的痰液标本作为研究对象,及时将痰标本送检,进行痰真菌涂片、痰免疫荧光染色、痰真菌培养等检查。以痰真菌培养为金标准,比较痰真菌涂片及真菌免疫荧光检测法在真菌培养阳性结果中的阳性率,比较两者的灵敏度、特异度和准确度。结果痰真菌免疫荧光检测结果灵敏度为92.86%,高于痰真菌涂片的71.42%,差异有统计学意义(P<0.05);痰真菌免疫荧光检测结果特异度为88.89%,高于痰真菌涂片的66.67%,差异有统计学意义(P<0.05);痰真菌免疫荧光检测结果准确度为93.33%,高于痰真菌涂片的70.00%,差异有统计学意义(P<0.05)。结论真菌免疫荧光检测法相较于痰真菌涂片法在慢性阻塞性肺疾病急性加重期快速诊断中的灵敏度、特异度和准确度更高,能够减少检查结果假阴性的发生,降低漏检率,值得推广应用。

Objective To compare the rapid diagnosis value between sputum fungal smear and sputum fungal immunofluorescence staining in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Sputum specimens from 60 patients with AECOPD diagnosed in Ji′an Hospital,Shanghai Dongfang Hospital from June 2019 to June 2020 were selected as the research objects.The sputum specimens were timely sent for examination of general fungal smear,immunofluorescence staining of sputum,culture of sputum fungi and others,and statistical data were collected.According to the gold standard of sputum fungal culture,the positive rate of fungal culture was compared between the methods of sputum fungal smear and immunofluorescence,as well as the sensitivity,specificity and accuracy.Results The sensitivity of the immunofluorescence assay of sputum fungus was 92.86%,which was higher than 71.42%of the sputum fungal smear,with statistically significant difference(P<0.05).The specificity of the sputum fungal immunofluorescence assay was 88.89%,which was higher than 66.67%of sputum fungal smear,with statistically significant difference(P<0.05).The accuracy of the immunofluorescence of sputum fungus was 93.33%,which was higher than 70.00%of the sputum fungal smear,with statistically significant difference(P<0.05).Conclusion Compared with the sputum fungal smear,the fungal immunofluorescence assay has higher sensitivity,specificity and accuracy in the rapid diagnosis of AECOPD,which can reduce the occurrence of false negative results and the rate of missing detection and is thus worthy to be applied widely.