血浆1，3-β-D 葡聚糖检测在侵袭性真菌感染中的诊断价值

摘要

Objective To investigate the diagnostic value and optimal threshold value of plasma 1,3-β-D-glucan test (G test)in the invasive fungal infections (IFI).Methods 46 patients diagnosed with IFI in our hospital from February 2012 to March 2014 were enrolled in this study,and 30 patients without IFI underwent surgical elective surgery in our hospital were selected as the neg-ative controls.The plasma 1,3-β-D-glucan content was quantitatively detected by using MB-80 microbial dynamic rapid detection system and its supporting G test kit.The results were evaluated by ROC curve for the determination of the optimal threshold value of G test.Results The plasma 1,3-β-D-glucan levels were (45.28±44.50)pg/mL in the IFI group and (8.62±4.85)pg/mL in the control group respectively,and the difference was statistically significant (P <0.05 ).The results of ROC curve analysis showed that the optimal threshold value of plasma 1 ,3-β-D-glucan used for diagnosis of IFI was 14.7 pg/mL;the area under the curve was up to 0.937;95% CI was between 0.888 and 0.990;the sensitivity and specificity were 88.9% and 90.3% respectively;G test had a better diagnostic efficiency.Conclusion The plasma 1 ,3-β-D-glucan test has a diagnostic application value for IFI,which can be used as the early warning indicator of IFI.%目的：研究血浆1，3-β-D 葡聚糖检测（G 试验）在侵袭性真菌感染（IFI）疾病中的诊断价值和最佳临界值。方法收集该院2012年2月至2014年3月 IFI 确诊患者46例，同时选取外科择期手术，排除 IFI 患者30例作为阴性对照；采用 MB-80微生物动态快速检测系统及配套 G 试验试剂盒定量检测血浆1，3-β-D 葡聚糖的水平，用 ROC 曲线进行评估，并确定 G 试验的最佳临界值。结果 IFI 组和对照组血浆1，3-β-D 葡聚糖水平分别为（45．28±44．50）pg／mL 和（8．62±4．85）pg／mL，两组比较差异有统计学意义（P ＜0．05）。ROC 曲线结果分析显示，血浆1，3-β-D 葡聚糖用于诊断 IFI 的最佳临界值为14．7 pg／mL，曲线下面积最大为0．937，95％置信区间为0．888～0．990，灵敏度和特异度分别为88．9％和90．3％，具有较好的诊断效率。结论血浆1，3-β-D 葡聚糖检测对于 IFI 具有诊断应用价值，可以用于 IFI 的早期预警指标。