摘要
目的探讨支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)半乳甘露聚糖(galactomannan,GM)检测在非中性粒细胞缺乏患者侵袭性肺曲霉病(invasive pulmonary aspergillosis,IPA)诊断中的价值。方法回顾性分析2014年1月至2021年12月住院并符合纳入标准的788例患者,根据EORTC/MSG诊断标准和专家共识,分为确诊IPA、临床诊断IPA、拟诊IPA和非IPA组,用统计学方法对BALF GM检测结果进行分析,比较不同阈值时BALF GM检测的灵敏度、特异性、约登指数。结果4例确诊IPA、156例临床诊断IPA为病例组,非IPA 160例为对照组。对于BALF GM检测,ROC曲线分析当cut-off≥0.935时,约登指数为0.969,是最佳的界值点,灵敏度为98.8%,特异性为98.1%。当cut-off≥1.51时,灵敏度为78.8%,特异性为100.0%。结论BALF GM检测在非中性粒细胞缺乏患者IPA诊断中具有重要意义。
Objective To explore the value of galactomannan testing of bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in non-neutropenic patients.Methods A retrospective analysis was conducted in 788 patients admitted to the hospital between January,2014 and December,2021.We then determined an optimal BALF galactomannan OD cut-off value for IPA in at-risk patients.Results There were a total of 160 cases(4 proven and 156 probable IPA)and 160 controls in this study.ROC curve demonstrated an optimum OD index cut-off of 0.935,with a high specificity(98.1%)and sensitivity(98.8%)for diagnosing IPA.With a cut-off≥1.51,BALF galactomannan sensitivity and specificity for diagnosing IPA were 78.8%and 100.0%,respectively.Conclusion Our study demonstrates that BALF galactomannan testing can be a safe and useful adjunct for the diagnosis of IPA in non-neutropenic patients.
作者
金欣
刘佳
左向华
丁同刚
李丽
白云石
陈建魁
JIN Xin;LIU Jia;ZUO Xianghua;DING Tonggang;LI Li;BAI Yunshi;CHEN Jiankui(Beijing Arion Cancer Hospital,Beijing 102613,China;The Fifth Medical Center,Chinese PLA General Hospital,Beijing 100071,China)
出处
《标记免疫分析与临床》
CAS
2024年第7期1189-1192,1218,共5页
Labeled Immunoassays and Clinical Medicine
基金
国家高技术研究发展计划(863计划)(编号:2011AA02A111)。
