摘要
目的:探讨半乳甘露聚糖(GM)试验在变应性支气管肺曲霉病诊断中的应用价值。方法:选取南京脑科医院2018年1月至2020年12月收治的87例疑似变应性支气管肺曲霉病患者作为观察组,另选取该院同期收治的肺部细菌感染患者87例作为对照组,观察用支气管肺泡灌洗GM试验、血清GM试验结果鉴别诊断两组患者病情的敏感度、特异度、阳性预测值、阴性预测值,并进行相关ROC曲线分析。结果:用支气管肺泡灌洗GM试验结果和血清GM试验结果同时阳性法鉴别诊断两组患者病情的敏感度为93.94%、特异度为98.83%、阳性预测值为98.58%、阴性预测值为96.24%、ROC曲线下面积(AUC)为0.905。与用支气管肺泡灌洗GM试验结果阳性法、血清GM试验结果阳性法相比,用支气管肺泡灌洗GM试验结果和血清GM试验结果同时阳性法鉴别诊断两组患者病情的敏感度、特异度、阳性预测值、阴性预测值、AUC均较高,差异有统计学意义(P<0.05)。结论:支气管肺泡灌洗GM试验结果和血清GM试验结果同时阳性法在变应性支气管肺曲霉病鉴别诊断中的应用价值较高。
Objective:To investigate the value of galactomannan(GM)test in the diagnosis of allergic bronchopulmonary aspergillosis.Methods:A total of 87 patients with suspected allergic bronchopulmonary aspergillus patients admitted to Nanjing Brain Hospital from January 2018 to December 2020 were selected as the observation group,and 87 patients with pulmonary bacterial infection admitted to Nanjing Brain Hospital during the same period were selected as the control group.The sensitivity,specificity,positive predictive value and negative predictive value of bronchoalveolar lavage GM test and serum GM test were observed,and the correlation ROC curve was analyzed.Results:The sensitivity,specificity,positive predictive value,negative predictive value and AREA under ROC curve(AUC)were 93.94%,98.83%,98.58%and 96.24%respectively by using bronchoalveolar lavage GM test results and serum GM test results simultaneously.Positive test results with bronchoalveolar lavage GM method,the positive test results serum GM method,compared with GM test results of bronchoalveolar lavage and serum GM test results and positive method to differential diagnosis the sensitivity of the two groups of patients,specific degree,positive predictive value,negative predictive value,AUC were higher,the difference was statistically significant(P<0.05).Conclusion:The simultaneous positive method of BRONchoalveolar lavage GM test results and serum GM test results is of high value in the differential diagnosis of allergic bronchopulmonary aspergillosis.
作者
朱剑楠
ZHU Jiannan(Department of Respiratory Medicine,Chest Department,Nanjing Brain Hospital,Nanjing 210029,China)
