摘要
目的探讨血清和肺泡灌洗液半乳甘露聚糖(GM)试验在肺曲霉病诊断中的应用价值。方法选取2015年6月—2019年6月南通大学附属建湖医院就诊的疑似肺曲霉病患者90例为研究对象。患者接受血清及肺泡灌洗液GM联合治疗,根据临床诊断比较不同患者血清及肺泡灌洗液GM值,ROC曲线分析血清及肺泡灌洗液GM值诊断肺曲霉病的诊断价值。结果90例疑似肺曲霉病患者中,确诊肺曲霉病39例,拟诊肺曲霉病21例,非肺曲霉30例。确诊和拟诊肺曲霉病患者血清及肺泡灌洗液GM值高于非肺曲霉患者(P<0.05)。血清、肺泡灌洗液GM值诊断肺曲霉病的ROC曲线下面积分别为0.794和0.870,截断值分别为0.43μg/L和0.88μg/L,灵敏度分别为74.00%和82.00%,特异性分别为75.00%和100.00%。采用并联试验的方式,血清联合肺泡灌洗液GM值诊断肺曲霉病的灵敏性和特异性分别为88.00%和85.00%。采用串联试验的方式,血清联合肺泡灌洗液GM值诊断肺曲霉病的灵敏性和特异性分别为70.00%和100.00%。结论血清和肺泡灌洗液GM试验在肺曲霉病诊断中有较好的应用价值,值得临床使用。
Objective To investigate the value of serum and alveolar lavage fluid galactomannan(GM)test in the diagnosis of pulmonary aspergillosis.Methods From June 2015 to June 2019,90 patients with suspected pulmonary aspergillosis treated in Jianhu Hospital Affiliated to Nantong University were selected as research subjects.Patients received a combination of serum and alveolar lavage fluid GM therapy.GM values of serum and alveolar lavage fluid of different patients were compared according to clinical diagnosis,and the ROC curve was used to analyze the diagnostic value of GM values of serum and alveolar lavage fluid in diagnosing pulmonary aspergillosis.Results Among 90 patients suspected of pulmonary aspergillosis,pulmonary aspergillosis was confirmed in 39 cases,pulmonary aspergillosis was suspected in 21 cases and non-pulmonary aspergillosis in 30 cases.The GM values of serum and alveolar lavage fluid in confirmed and suspected pulmonary aspergillus patients were higher than those in non-aspergillus patients(P<0.05).The area under curve of ROC of GM value of serum and alveolar lavage fluid in diagnosing pulmonary aspergillosis were 0.794 and 0.870 respectively,the cut-off values were 0.43 and 0.88 respectively,the sensitivity were 74.00%and 82.00%respectively,the specificity were 75.00%and 100.00%respectively.By parallel test,the sensitivity and specificity of serum combined with alveolar lavage fluid GM value for diagnosis of aspergillus disease were 88.00%and 85.00%;by tandem test,the sensitivity and specificity of serum combined with alveolar lavage fluid GM for diagnosis of aspergillosis were 70.00%and 100.00%.Conclusion The GM test of serum and alveolar lavage fluid has a good application value in the diagnosis of pulmonary aspergillosis and is worth clinical use.
作者
周永军
孟亚奇
鲍姨琴
王柱
ZHOU Yongjun;MENG Yaqi;BAO Yiqin;WANG Zhu(Department of Respiratory Medicine,Jianhu Hospital Affiliated to Nantong University,Jiangsu Province,Yancheng224700,China;Department of Respiratory and Critical Care Medicine,Jiangsu Provincial People’s Hospital,Jiangsu Province,Nanjing210029,China;Department of Respiratory and Critical Care Medicine,Wuhu Second People’s Hospital,Anhui Province,Wuhu241000,China;Department of Thoracic Surgery,Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221000,China)
出处
《中国医药导报》
CAS
2021年第11期125-128,共4页
China Medical Herald
基金
江苏省实验诊断学重点实验室(ZDXKB2016005)。
关键词
血清
肺泡灌洗液
半乳甘露聚糖试验
肺曲霉病
Serum
Alveolar lavage fluid
Galactomannan test
Pulmonary aspergillosis
