深部真菌感染诊断中G实验与真菌培养联合检测研究

G Experiment and Fungal Culture Joint Detection Research of Diagnosis of Deep Fungus Infection

目的:探讨在深部真菌感染(IFI)诊断中G实验与真菌培养联合检测的价值。方法:选取2021年1月—2022年5月北京航天总医院同时做过G实验检测和真菌培养的164例患者的检测资料,取不同患者的痰液、引流液、胸腹水、尿液、肺泡灌洗液、血液和脑脊液等进行G实验和真菌培养,分别测定两种检测方法的阳性率、灵敏度、特异性等进行分析。结果:所有检测患者中,G实验阳性91例、真菌培养阳性72例、二者均阳性66例、均阴型76例。G实验的灵敏度为93.18%、特异性为83.95%、阳性预测值为85.71%、阴性预测值为93.15%;真菌培养的灵敏度为83.13%、特异度为96.3%、阳性预测值为95.83%、阴性预测值为84.78%;两种方法联合诊断的灵敏度为97.59%、特异度为97.53%、阳性预测值为97.56%、阴性预测值为96.34%。结论:在IFI的诊断中G实验在感染早期诊断有一定意义,真菌培养可以基本确定真菌感染以及感染的菌属;G实验和真菌培养联合检测对于诊断IFI具有明显的临床诊断价值。

Objective:To evaluate the G experiment and fungal culture the value of combined detection in the diagnosis of deep fungus infection.Methods:164 patients who received G experimental tests and fungal culture in the hospital from January 2021 to May 2022 were selected.Phlegm,drainage fluid,chest water,urine,alveolar lavage fluid,blood and cerebrospinal fluid,etc.,were collected among different patients to conduct G experiment and fungus culture.The positive rate,sensitivity and specificity of detection methods were analyzed.Results:Among all patients,there were 91 positive cases,72 fungal culture positive cases,66 both positive cases,and 76 all negative cases.G test sensitivity was 93.18%,specificity was 83.95%,positive predictive value was 85.71%,negative predictive value was 93.15%.Fungal culture sensitivity was 83.13%,specificity was 96.3%,positive predictive value was 95.83%,and negative predictive value was 84.78%.Two methods combined diagnostic sensitivity was 97.59%,and specificity was 97.53%.Positive predictive value was 97.56%,and negative predictive value of 96.34%.Conclusion:G experiment is meaningful to early diagnosed of deep fungus.Fungus cultivation can virtually certain fungal infection and infected bacterial genus.G experiment and fungal culture combined diagnosis of deep fungus infection has obvious clinical diagnostic value.