摘要
目的探讨炎症因子检测、半乳甘露聚糖抗原检测(GM试验)和(1,3)-β-D葡聚糖试验(G试验)对儿科重症监护室(PICU)患儿侵袭性真菌病(IFD)的早期诊断价值。方法选取具有IFD高危因素的患儿250例分为确诊IFD组、拟诊IFD组和非IFD组,检测患儿血清和肺泡灌洗液中炎症因子白细胞介素(IL)-10、IL-6、IL-8和IL-17表达水平,并分别进行G试验和GM试验。比较3组患儿炎症因子表达水平差异,以及G试验和GM试验诊断IFD的灵敏度、特异度、阳性预测值和阴性预测值。结果确诊IFD组和拟诊IFD组患儿血清中IL-10、IL-6、IL-8和IL-17表达水平明显高于非IFD组,肺泡灌洗液中IL-6、IL-8表达水平明显高于非IFD组,差异均有统计学意义(P<0.05)。G试验和GM试验联合诊断IFD的灵敏度为95.97%,特异度为93.65%,阳性预测值为93.70%,阴性预测值为95.83%,均明显高于单项检测,差异均有统计学意义(P<0.05)。结论GM试验和G试验联合检测能明显提高对PICU患儿IFD早期诊断的灵敏度,为临床早期治疗提供依据;动态监测PICU患儿炎症因子表达水平,有助于判断IFD的严重程度和治疗效果及预后。
Objective To investigate the early stage diagnostic value of inflammatory cytokines detection,galactomannan test(GM test)and(1,3)-β-D glucan test(G test)in pediatric intensive care unit(PICU)children patients with invasive fungal disease(IFD).Methods A total of 250 children inpatients with high risk factors of IFD were chosen and divided into the definite diagnosis IFD group,suspected IFD group and nonIFD group.The inflammatory factors interleukin(IL)-6,IL-8,IL-10 and IL-17 expression levels in serum and alveolar lavage fluid were detected.And the G test and GM test were carried out respectively.The differences of inflammatory factors levels as well as the sensitivities,specificities,positive predictive values,negative predictive values of GM test and G test for diagnosing IFD were compared among 3 groups.Results The expression levels of serum IL-10,IL-6,IL-8 and IL-17 in the definite diagnosis IFD group and suspected IFD group were significantly higher than those in the non-IFD group(P<0.05),and the levels of IL-6 and IL-8 in the alveolar lavage fluid were significantly higher than those in the non-IFD group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of the combined detection of G test and GM test for diagnosing IFD were 95.97%,93.65%,93.70% and95.83%,respectively,all were significantly higher than those in the single test,and the difference was statistically significant(P<0.05).Conclusion The combination of GM test and G test can significantly improve the sensitivity in early diagnosing IFD in PICU patients,which provides the basis for early clinical treatment.Dynamic monitoring of the expression levels of inflammatory factors in PICU children patients is conducive to judge the severity of IFD,treatment effect and prognosis.
作者
陆丹
郝英婵
LU Dan;HAO Yingchan(Department of Clinical Laboratory,Hubei Provincial Maternal and Child Health Care Hospital,Wuhan,Hubei 430000,China)
出处
《检验医学与临床》
CAS
2020年第10期1390-1393,共4页
Laboratory Medicine and Clinic
