【摘要】 目的:评价支气管肺泡灌洗液(BALF)中(1,3)-β-D葡聚糖(BG)含量的检测(G试验)对侵袭性肺部真菌感染(IPFI)的诊断价值,并寻找最佳诊断阈值。方法:选取2015年7月-2017年3月本院经病理组织学诊断或临床诊断的IPFI患者30例作为试验组,另选取同期本院单纯肺炎患者30例为对照组。两组患者均行支气管镜肺泡灌洗术,同时检测患者BALF和血液的BG的含量,评价其诊断效能,并绘制ROC曲线。结果:两组患者BALF和血液G试验的BG水平比较,差异均有统计学意义(P<0.001);试验组患者组内的BALF与血液G试验的BG水平比较,差异有统计学意义(P<0.05),但对照组患者组内的BALF与血液G试验的BG水平比较,差异无统计学意义(P>0.05)。BALF的G试验灵敏度90%、特异度83.33%、准确度86.67%、Youden指数0.73、阳性预测值84.38%、最佳诊断阈值为42.5 ng/L;血液的G试验灵敏度73.33%、特异度90.00%、准确度81.67%、Youden指数0.63、阳性预测值88.00%、最佳诊断阈值20 ng/L。结论:BALF的G试验较血液的G试验对IPIF诊断可能更有临床价值。更多还原

【Abstract】 Objective:To evaluate the diagnostic value of bronchoalveolar lavage fluid(BALF)(1,3)-β-D glucan(BG) content(G test) in invasive pulmonary fungal infection(IPFI),and to find the best diagnostic threshold.Method:30 patients with IPFI diagnosed by histopathology or clinical diagnosis in our hospital from July 2015 to March 2017 were selected as experimental group,30 patients with simple pneumonia in the same period were selected as control group.They were treated with bronchoalveolar lavage,the BG content of BALF and blood were detected,the diagnostic efficacy of BALF and blood were evaluated,and the ROC curve was drawn.Result:The BG levels of BALF and blood G test in two groups were compared,the differences were statistically significant(P<0.001);the BG levels of BALF and blood G test in experimental group were compared,the difference was statistically significant(P<0.05),the BG levels of BALF and blood G test in control group were compared,the difference was not statistically significant(P>0.05).The sensitivity of BALF for G test was 90%,specificity was 83.33%,accuracy was 86.67%,Youden index was 0.73,positive predictive value was 84.38%,and the optimal diagnostic threshold was 42.5 ng/L.The sensitivity of blood G test was 73.33%,specificity was 90.00%,accuracy was 81.67%,Youden index was 0.63,positive predictive value was 88.00%,and the best diagnostic thresholdwas 20 ng/L.Conclusion:The G test of BALF may be more valuable for IPFI diagnosis than G test of blood.更多还原