【摘要】 目的分析血浆与支气管肺泡灌洗液(BALF)(1,3)-β-D葡聚糖检测在小儿侵袭性肺部真菌感染(IPFI)中的诊断价值。方法选取武汉市儿童医院在2014年12月-2015年12月收治的、符合纳入标准的IPFI患儿50例为试验组,同期在本院选择大叶性肺炎患儿以及非肺炎患儿各50例为大叶性肺炎组和非肺炎组,其中非肺炎组患儿均有支气管异物。对所有患儿行支气管肺泡灌洗,收集灌洗液并抽血3~5 ml,所有样本均应用(1,3)-β-D葡聚糖检测,并绘制ROC曲线。结果所有样本均成功操作。试验组、大叶性肺炎组和非肺炎组的BALF应用(1,3)-β-D葡聚糖检测值分别为(239.59±153.71)pg/ml、(14.53±6.71)pg/ml和(14.11±5.92)pg/ml,试验组与大叶性肺炎组和非肺炎组差异有统计学意义(P<0.01);血浆应用(1,3)-β-D葡聚糖检测值分别为(102.83±30.26)pg/ml、(11.25±4.74)pg/ml和(4.12±2.86)pg/ml,差异同样具有统计学意义(P<0.01)。ROC曲线表明,BALF应用(1,3)-β-D葡聚糖检测具有更好的灵敏度和特异度。结论 IPFI患儿的血浆和BALF应用(1,3)-β-D葡聚糖检测具有较好的临床诊断价值,但血浆检测影响因素较多,应首选BALF进行检测。更多还原

【Abstract】 Objective To analyze the value of(1,3)-β-D-glucan detection in plasma and bronchoalveolar lavage fluid(BALF) in diagnosis of invasive pulmonary fungal infection(IPFI) in children.Methods Fifty children meeting the inclusion criteria of IPFI and treated in the hospital from December 2014 to December 2015 were selected as experimental group,fifty children with lobar pneumonia were selected from the hospital during the same period as lobar pneumonia group,fifty children with foreign bodies in bronchia and without pneumonia were selected from the hospital during the same period as non-pneumonia group.Bronchoalveolar lavage was performed in the three groups,lavage fluid was collected,and 3-5 ml blood specimens were obtained,then(1,3)-β-D-glucan levels were detected.ROC curve were drawn.Results All samples were successfully operated.The levels of(1,3)-β-D-glucan in BALF in experimental group,lobar pneumonia group,and non-pneumonia group were(239.59±153.71) pg/ml,(14.53±6.71) pg/ml,and(14.11±5.92) pg/ml,respectively,there was statistically significant difference(P<0.01).The levels of(1,3)-β-D-glucan in plasma in experimental group,lobar pneumonia group,and non-pneumonia group were(102.83±30.26) pg/ml,(11.25± 4.74) pg/ml,and(4.12± 2.86) pg/ml,respectively,there was statistically significant difference(P<0.01).ROC curve showed that(1,3)-β-D-glucan detection in BALF had better sensitivity and specificity.Conclusion(1,3)-β-D-glucan detection in BALF and plasma has good value in clinical diagnosis of IPFI in children,but plasma detection has many influencing factors,BALF should be the first choice for the detection.更多还原