摘要
在恶性血液病、异体干细胞移植或实体器官移植患者等高危人群中,侵袭性曲霉病(IA)的早期诊断很重要,因为未能诊断IA或诊断延迟将导致死亡率增高。IA传统检测方法敏感性和特异性都很低,以及IA患者数量的不断增加,导致新方法的发展。这些方法包括抗原的检测如检测血清中的半乳甘露聚糖(GM)和真菌-β1,3-葡聚糖等,以及不同的分子方法(PCR法)。GM检测已商业化,但仍需大规模评价,尤其是在儿童。已发展了不同的PCR方法,针对不同的基因区域,包括各种扩增子的检测方法。这些分子方法就敏感性和特异性而言有很高的潜力,但可行性变化很大,到目前为止还没有标准化。总之,新的非培养诊断法的优点是非侵入性、简单、快速、敏感。因此,它们可能有助于IA的早期诊断,减少经验性抗真菌治疗并监测抗真菌治疗疗效。
In high-risk patients,such as patients with hematologic malignancies,or patients after allogeneic stem-cell or solid-organ transplantation,early diagnosis of invasive aspergillosis（IA） is essential,as missing or delayed diagnosis of IA results in increasing rates of mortality.However,diagnosis of IA is difficult because classic tests have low sensitivity and specificity.The limited sensitivity and specificity of conventional assays for the detection of IA and the growing number of IA patients have led to the development of new assays.These methods include antigen detection systems,such as galactomannan（GM） assay,and different molecular methods（PCR assays）.The GM assay is commercially available.However,it still need to be evaluated in large patient cohorts,especially children.A range of different PCR assays have been developed,targeting different gene regions,including a variety of amplicon detection methods.These molecular assays provide high potential in terms of sensitivity and specificity,but vary widely in their feasibility and up to now have not been standardised.Taken together,new non-culture-based diagnostic assays are noninvasive,simple,rapid and highly sensitive.Thus,they might be valuable tools to make early diagonosis,to reduce empirical antifungal therapy and to monitor the therapy.
出处
《医学研究生学报》
CAS
2009年第12期1328-1332,共5页
Journal of Medical Postgraduates
基金
江苏省博士后基金资助项目(批准号:0802032c)
关键词
侵袭性曲霉病
诊断方法
Invasive aspergillosis Detection assays
