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- 2018
血浆(1-3)-β-D-葡聚糖与侵袭性肺部真菌感染的关系
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Abstract:
摘要 目的： 探讨血浆(1,3)-β-D-葡聚糖在侵袭性肺部真菌感染(IPFI)诊疗中的临床价值及与真菌菌属之间的关系.方法: 选取78例IPFI患者和55名健康人群,检测其治疗前的血浆(1,3)-β-D-葡聚糖水平,并对IPFI患者肺泡灌洗液BALF和痰液进行真菌培养;同时监测IPFI患者抗真菌治疗第7天和第14天的血浆(1,3)-β-D-葡聚糖水平,及相应的真菌培养阳性率;结果采用SPSS 19.0进行统计分析.结果:血浆(1,3)-β-D-葡聚糖在IPFI患者中的阳性率明显优于肺泡灌洗液和痰液真菌培养的阳性率(P<0.05).IPFI各真菌菌属组患者血浆(1,3)-β-D-葡聚糖水平均显著高于健康对照组(P<0.05);曲霉菌属组与隐球菌属组的血浆(1,3)-β-D-葡聚糖水平也有显著差异(P<0.05).原有治疗方案缓解组患者治疗第7天、第14天血浆(1,3)-β-D-葡聚糖水平较治疗前均有显著性下降(P<0.05);调整治疗方案缓解组患者治疗第14天血浆(1,3)-β-D-葡聚糖水平较治疗前和治疗第7天也有显著降低(P<0.05);病情稳定组患者血浆(1,3)-β-D-葡聚糖水平在治疗过程中无明显变化(P>0.05);病情进展组患者治疗第7天、第14天血浆(1,3)-β-D-葡聚糖水平较治疗前有显著上升(P<0.05);各组患者真菌培养阳性率在治疗过程中均无显著性差异(P>0.05).结论: 血浆(1,3)-β-D-葡聚糖在侵袭性肺部真菌感染的诊断、早期经验性用药的指导和治疗方案的调整、及治疗过程的检测等方面均有重要的临床价值.
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