%0 Journal Article
%T 血清G和GM试验对侵袭性肺曲霉菌病的诊断价值
%A 李乐乐　周雨笋　杨甜　刘淑慧　任远中　李慧
%J -
%D 2020
%R 10.13362/j.jpmed.202002015
%X 摘要 目的　探讨血清1,3-β-D-葡聚糖（G）和半乳甘露聚糖（GM）试验对侵袭性肺曲霉菌病（IPA）的诊断价值。 方法　回顾性分析2017年6月—2018年12月我院68例IPA住院患者（IPA组）及同时期128例非IPA住院患者（非IPA组）的血清G和GM试验结果，绘制受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）、cut-off值，以及G试验和GM试验诊断IPA的灵敏度和特异度等。 结果　IPA组和非IPA组血清中G的含量分别为(203.03±56.26)和（29.42±4.71）μg/L，血清中GM的含量分别为（1.14±0.62）和（0.32±0.07）μg/L，IPA组均显著高于非IPA组，差异有统计学意义（t=3.537、5.308，P＜0.05）。G试验和GM试验ROC曲线的AUC分别为0.637和0.756，各自相应的cut-off值分别为35.60和0.46 μg/L。在该cut-off值下，G试验和GM试验诊断IPA的灵敏度分别为82.35%、55.47%，特异度分别为61.76%、80.47%，两者诊断IPA的灵敏度和特异度比较差异均有统计学意义（χ2=7.16、18.37，P＜0.05）。 结论　G试验和GM试验对IPA有较高的诊断价值，两者作为辅助诊断IPA的重要检测技术，优势互补；确定合适的诊断IPA的G试验和GM试验的cut-off值，将有助于提高IPA的诊断率。<br>Abstract：Objective　To investigate the value of serum (1,3)-β-D-glucan (G) and galactomannan (GM) tests in the diagnosis of invasive pulmonary aspergillosis (IPA). Methods　A retrospective analysis was performed for the results of serum G and GM tests of 68 patients with IPA (IPA group) and 128 patients without IPA (non-IPA group) who were hospitalized in our hospital from June 2017 to December 2018. The receiver operating characteristic (ROC) curve was plotted to calculate the area under the ROC curve (AUC), cut-off value, and the sensitivity and specificity of G-test and GM-test in the diagnosis of IPA. Results　 Compared with the non-IPA group, the IPA group had significantly higher serum levels of G ((203.03±56.26) μg/L vs (29.42±4.71) μg/L,t=3.537,P<0.05)) and GM ((1.14±0.62) μg/L vs (0.32±0.07) μg/L,t=5.308,P<0.05)). The AUCs of G-test and GM-test were 0.637 and 0.756, respectively, with the cut-off values of 35.60 μg/L and 0.46 μg/L, respectively. At the above cut-off values, G-test had a sensitivity of 82.35% and a specificity of 61.76% in the diagnosis of IPA, while GM-test had a sensitivity of 55.47% and a specificity of 80.47%, and there were significant differences in sensitivity and specificity between the two tests (χ2=7.16,18.37,P<0.05). Conclusion　Both G-test and GM-test have a high diagnostic value for IPA and can complement each other’s advantages, and therefore, they can be used as important detection techniques for the auxiliary diagnosis of IPA. The suitable cuts-off values of G-test and GM-test for the diagnosis of IPA should be determined to improve the diagnostic rate of IPA
%K 侵袭性肺曲霉菌病
%K 1
%K 3-β-D-葡聚糖
%K 半乳甘露聚糖
%K ROC曲线
%K 早期诊断
%K cut-off值<br>Invasive pulmonary aspergillosis
%K 1
%K 3-β-D glucon
%K Galactomannan
%K ROC curve
%K Early diagnosis
%K Cut-off value
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202002015