G试验联合 GM 试验在恶性血液病侵袭性真菌感染的诊断价值

摘要

Objective: To explore the diagnostic value of plasma G(l,3-β-D glucan) /GM ( galactomannan) combined detection in diagnosis of invasive fungal infections(IFI) in hematological malignancies patients. Methods; The concentration of plasma 1 ,3 - β - D glucan and galactomannan was detected by MB - 80 Microbiology Kinetic Rapid Detection System and ELISA. There were 2 patients diagnosed as proven IFI,23 as probable IFI, 175 as possible IFI and 149 as no IFI. Results: G and GM test at a cutoff of 20pg/ml and 0. 5 respectively, the sensitivity and specificity of G test were 77% and 89. 9% ,with a positive predictive value (PPV) of 91. 1% and a negative predictive value (NPV) of 74. 4%. The sensitivity and specificity of G/GM test were 100% and 90. 4% respectively, with a positive predictive value (PPV) of 85.9% and a negative predictive value (NPV) of 100%. Conclusion:G/GM test is an early and rapid method for diagnosis of IFI in hematological malignancies patients.%目的:探讨血浆1,3-β-D葡聚糖检测(G实验)联合曲霉半乳甘露聚糖检测(GM试验)对恶性血液病侵袭性真菌感染(IFI)的诊断价值.方法:应用MB-80微生物动态快速检测系统和酶联免疫吸附法定量检测血浆1,3-β-D葡聚糖及半乳甘露聚糖的含量,将检测结果及临床特征进行分析.按照欧洲癌症研究治疗组织及真菌研究组(EORTC/MSG)诊断标准,在349例患者中,确定诊断2例,临床诊断23例,临床拟诊175例,排除诊断149例.结果:G、GM试验分别以20ng/ml、0.5为诊断界值,G试验的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为77％、89.9％、91.1％、74.4％.G/GM试验的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为100％、90.4％、85.9％、100％.结论:C试验联合GM试验是诊断恶性血液病患者IFI的早期、快速的方法.