【摘要】 目的:评价血清1,3-β-D葡聚糖(G)和半乳甘露聚糖(GM)抗原联合检测对血液肿瘤患者侵袭性真菌感染(IFI)的早期诊断价值。方法:42例中性粒细胞减少伴发热,经广谱抗生素治疗无效的血液病患者,根据临床回顾性诊断标准定义阳性和阴性病例。采用ELISA试剂盒检测患者血清G和GM,分别计算GM试验和G试验及联合检测的灵敏度、特异度、阳性和阴性预测值。结果:以I值>1.0为GM试验阳性,G浓度>60 pg/L为G试验阳性计算,GM试验和G试验联合检测的灵敏度、特异度、阳性和阴性预测值77.8%,90.3%,82.4%,87.5%;G试验的灵敏度和阳性预测值高,但GM试验的特异度高。结论:GM试验和G试验联合检测提高试验的敏感度,减少了假阴性的发生,对早期诊断IFI有一定的临床意义。更多还原

【Abstract】 Objective:To evaluate the value of serum galactomannan(GM) enzyme immunoassay combine with 1,3 beta-glucan(G) assay for diagnosis of invasive fungal infection(IFI) in hematological disorders.Method:Blood samples were obtained from 42 patients with neutropenic hematological disorder,fever and shown no response to broad-spectrum antibiotics therapy.Serum concentration of GM and G were detected by enzyme linked immunosorbent assay.The proven IFI and non-IFI patients were defined by retrospective clinical analysis according to domestic IFI diagnostic criteria.Result:GM positive was defined as I index>1.0 and G positive was defined as G>60 ng/L,The sensitivity an specificity of both GM and G assay were 77.8% and 90.3% and the positive and negative predictive values were 82.4% and 87.5% respectively.The performance of G-based diagnosis appears to be better for sensitivity.GM assay was shown to have a higher specificity than BG assay.Conclusion:Serum GM enzyme immunoassay combine with 1,3 beta-glucan(G) assay for diagnosis of IFI in hematological disorders increased sensitivity of detecting IFI and decreased false negative cases,and it could be a more reliable method for early diagnosis of IFI.更多还原