目的：探究血清及支气管肺泡灌洗液（BALF）中半乳甘露聚糖（GM）水平对侵袭性肺曲霉感染（IPA）的诊疗价值。方法选择疑似IPA的96例肺部疾病患者作为研究对象，确诊IPA的有4例，临床诊断IPA的有16例，拟诊IPA的有10例，共有30例患者纳入观察组。诊断非IPA的66例为对照组。采用单克隆体双层夹心酶联免疫吸附测定（ELISA）检测方法进行血清和BALF的GM检测；并比较两种GM检测方法的诊断效率。结果观察组中的BALF GM 值和血清GM值均明显高于对照组，差异均有统计学意义（t分别=5.76、3.79，P均＜0.05）；而在观察组中的BALF GM值高于同组的血清GM值，差异有统计学意义（t=4.46，P＜0.05）。当界定GM值≥0.5时，BALF GM检测的灵敏度、阳性预测值和阴性预测值都高于血清GM检测，仅特异度略低于血清GM检测。而当界定GM值≥1.0时，BALF GM检测的灵敏度、阴性预测值、特异度和阳性预测值都高于血清GM检测。结论在IPA的诊断中，BALF的GM 检测比血清 GM检测具有更好的效果，更有利于早期诊断和治疗。%Objective To study the diagnostic value of detecting galactomannan (GM) in serum and bronchoalveolar lavage fluid (BALF) among the patients with invasive pulmonary aspergillosis(IPA). Methods A total of 96 cases of sus-pected IPA with lung disease were selected as research subjects. There were 3 cases of definite diagnosis of IPA, 16 cases of clinical diagnosis of IPA and 10 cases of suspected IPA that included in the observation group and 66 cases of non-IPA as the control group. The GM in serum and BALF were detected by ELISA, and the diagnostic efficiencies of two GM test-ing were analyzed. Results The GM in BALF and serum of the observation group were significantly higher than the control group (t=5.76,3.79,P<0.05). The GM in BALF of observation group was significantly higher than the GM in serum (t=4.46,P<0.05). When the cut-off of GM was equal or greater than 0.5, the sensitivity, positive predictive value and nega-tive predictive value of GM in BALF were significantly higher than GM in serum while the specificity was lower than GM in serum. When the cut-off of GM was equal or greater than 1.0, the sensitivity, negative predictive value, specificity and positive predictive values of GM in BALF were significantly higher than GM in serum. Conclusion In the diagnosis of I-PA, diagnostic efficiencies of GM in BALF is better than GM in serum.
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