Objective To evaluate the diagnostic value of β-glucosan on the Candida infected ventila-tor-associated pneumonia(VAP).Methods Eighty VAP patients in Puer People′s Hospital during Jun. 2011 and Nov.2013 were enrolled in the study and divided into candida group and control group based on the deep sputum culture results.The clinical data and levels of β-glucosan,procalcitonin ( PCT) ,interleukin (IL)-6,IL-8 and C reactive protein (CRP) were measured in all patients.Pearson relation analysis was used to evaluate the relationship between β-glucosan and inflammatory markers.receiver operator characteristic (ROC) curve analysis was used to evaluate the diagnostic value of BG on the Candida VAP.Results The levels of β-glucosan of the candida group were significantly higher than the control group [ ( 85.5 ± 15.7) ng/L vs (75.2 ±21.5) ng/L,P<0.05].Only CRP was relative in all VAP patients(r=0.658,P<0.05).The levels of β-glucosan showed positive relation with PCT,IL-6 and CRP in candida group(r =0.654,r=0.571,r=0.795,P <0.05),and was weakly correlated with IL-8(r =0.566,P <0.05).The ROC analysis showed that the AUC of β-glucosan was 0.812,the optimal cut-off value was 92.5 ng/L,the sensitivity and specificity were 54.6% and 94.0% respectively.Conclusion β-glucosan positivity in patients with a suspected VAP is a marker for Candida infection in the lung with high specificity .%目的：探讨β葡聚糖对呼吸机相关性肺炎（ VAP）患者假丝酵母菌的诊断价值。方法选取2011年6月至2013年11月入住普洱市人民医院呼吸内科的诊断为 VAP的患者共80例。根据深部痰培养结果将患者分为假丝酵母菌感染组（22例）和其他病原菌组（58例），统计两组患者的一般资料和临床预后情况，并检测患者的血清β葡聚糖、降钙素原（PCT）、白细胞介素（IL）－6、IL－8和C反应蛋白（ CRP）水平。应用Pearson直线相关分析β葡聚糖水平和炎症指标的相关性，并建立受试者工作特征曲线（ ROC曲线）评价β葡聚糖水平对假丝酵母菌感染的VAP的诊断价值。结果假丝酵母菌组的血清β葡聚糖水平显著高于其他病原菌组[（85．5±15．7） ng／L 比（75．2±21．5） ng／L， P＜0．05]。在VAP患者中只与CRP存在一定的相关性（r＝0．658，P＜0．05）。假丝酵母菌组血清β葡聚糖水平与PCT、IL－6和CRP均有显著相关性（r＝0．654，r＝0．571，r＝0．795，P ＜0．05），与 IL－8也有较弱的相关性（r ＝0．566，P ＜0．05）。β葡聚糖水平对诊断假丝酵母菌感染的曲线下面积为0．812，最佳截断值为92．5 ng／L，灵敏度为54．6％，特异度为94．0％。结论β葡聚糖对 VAP 患者的假丝酵母菌感染具有一定的诊断价值，特异度高。
展开▼
