摘要
目的研究1-3-β-D葡聚糖(BG)、血清C-反应蛋白(CRP)及白细胞(WBC)检测对侵袭性肺部真菌感染(IFI)老年病人的诊断临床意义。方法采用前瞻性单中心观察性研究,纳入2013~2016年我院收治的IFI老年病人59例为试验组,同期我院非真菌肺炎老年病人61例为对照组,检测并分析血清G试验、血清CRP、WBC分类计数,进行痰涂片及病原学培养,绘制其BG受试者的工作特性(ROC)曲线,评价各检测指标的临床价值。结果试验组在入组时BG水平明显高于对照组(P=0.01),治疗结束时2组差异无统计学意义(P>0.05);2组CRP、WBC计数水平在入组时差异无统计学意义(P>0.05),治疗结束时试验组CRP、WBC计数水平低于对照组(P<0.05)。入组时血清BG的ROC曲线下面积(AUC)为0.932(P=0.001),灵敏度为87.7%,特异度为93.1%。结论 BG在早期鉴别诊断IFI老年病人有较好的灵敏度和特异度,联合检测血清BG、CRP、WBC计数在鉴别诊治IFI老年病人有较高临床价值。
Objective To investigate the clinical diagnosing value of detecting 1-3-β-D-glucan（G test）,C-reactive protein（CRP）,white blood cells（WBC） in the elderly patients with invasive pulmonary fungal infection（IFI）.Methods A prospective single-center observational study was carried out from 2013 to 2016 in our hospital,and 59 cases of elderly patients with IFI were enrolled as experimental group,61 cases of elderly patients with non-fungal pneumonia enrolled as control group at the same period.The serum G test,the detection of CRP and leukocytes,sputum smear and etiology culture were performed.The curve of G test by operating characteristics（ROC） was drawn,and the clinical value of the indicators was evaluated.Results The level of BG in the experimental group was significantly higher than that in the control group before treatment（P = 0.01）.While there was no significant difference between the two groups at the end of treatment（P0.05）.There were no significant differences in the levels of CRP and leukocytes between the two groups before treatment（P〈0.05）.At the end of treatment,the levels of CRP and leukocytes in the experimental group were lower than those in the control group（P〈0.05）.The area under the ROC curve of serum BG at the enrollment was 0.932（P = 0.001）,and the sensitivity was 87.7% and the specificity was 93.1%.Conclusions Serum BG has good sensitivity and specificity in early diagnosis of IFI in the elderly patients.The combined detection of serum BG,CRP,WBC count has high clinical value in the differential diagnosis of IFI in the elderly patients.
出处
《实用老年医学》
CAS
2018年第1期57-59,共3页
Practical Geriatrics
基金
桂林市科技局科技攻关计划基金课题(20170109-27)
