非培养检测方法在终末期肝病合并侵袭性真菌感染诊断中的应用

The application of non-culture tests in the diagnosis of end-stage liver disease complicated with invasive fungal infection

侵袭性真菌感染(IFI)已经成为终末期肝病(ESLD)患者治疗失败乃至死亡的重要原因。然而,由于临床表现不一,真菌培养阳性率低及培养周期时间长等,ESLD合并IFI的早期、准确诊断具有挑战性。近年来,非培养检测方法如直接显微镜镜检(包括真菌荧光染色)、血清学检测方法及分子生物学方法被引入IFI的检测,逐渐成为有广泛临床应用前景的早期检测手段。本文就ESLD合并IFI的流行病学、IFI非培养检测方法及其在ESLD合并IFI诊断中的应用作一阐述。

End-stage liver disease(ESLD)complicated with invasive fungal infection(IFI)has become one of the most important causes of deterioration even death in patients with ESLD.However,due to the atypical clinical manifestations,low positive rate of fungal culture and long culture cycle time,early and accurate diagnosis of ESLD with IFI is a big challenge.In recent years,some novel non-culture tests involving direct microscopy examination(including fungal fluorescence staining),serological tests,and molecular biology-based tests have facilitated early diagnosis of IFI with broad clinical application prospects.In this article,the epidemiology of ESLD complicated with IFI,the non-culture tests for IFI,and the application of non-culture tests in the diagnosis of ESLD complicated with IFI are overviewed.