血清和肺泡灌洗液G试验、GM试验在侵袭性肺部真菌感染中的诊断价值研究
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四川省遂宁市院校科技战略合作项目(2021SNXNYD02);


Diagnostic value of G test and GM test in serum and bronchoalveolar lav-age fluid for invasive pulmonary fungal infection
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    摘要:

    目的:以侵袭性肺部真菌感染患者(IPFI)为例,分析血清、肺泡灌洗液(1-3)-β-D葡聚糖检测[(1-3)-serum β-D test, G]试验、半乳甘露聚糖检测(GM)试验在其早期诊断中的应用价值。方法:选取53例IPFI患者作为IPFI组;另选取同期就诊的53例肺部细菌感染患者作为对照组。所有患者均行血清和肺泡灌洗液G试验、GM试验检测。比较两组患者的检测结果,分析血清和肺泡灌洗液G试验、GM试验的诊断价值。结果:两组患者的血清G试验、GM试验和肺泡灌洗液G试验、GM试验检测结果比较,差异均有统计学意义(P<0.05);以组织病理学检查结果为金标准,血清G试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为69.81%、100.00%、84.91%、100.00%和76.81%;血清GM试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为41.51%、100.00%、70.75%、100.00%和63.10%;肺泡灌洗液G试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为100.00%、73.58%、86.79%、79.10%和100.00%;肺泡灌洗液GM试验诊断IPFI的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为77.36%、64.15%、70.75%、68.33%和73.91%。受试者工作特征(ROC)曲线显示,血清G试验、GM试验和肺泡灌洗液G试验、GM试验检测结果诊断IPFI的曲线下面积(AUC)分别为0.804、0.862、0.978、0.987,均对IPFI有一定鉴别价值。结论:血清和肺泡灌洗液G试验、GM试验检测对IPFI诊断均有一定诊断价值,根据阈值的不同敏感度、特异度互有优劣,临床应结合实际情况参考多种检测结果综合评估。

    Abstract:

    Objective:To explore the early diagnostic value of(1-3)β-D glucan test(G test)and galactomannantest(GM test)in serum and bronchoalveolar lavage fluid(BALF)for patients with invasive pulmonary fungal infection(IPFI).Methods:A total of 53 patients with IPFI and 53 patients with pulmonary bacterial infectionin the hospital were enrolled as IPFI group and control group,respectively.All patients underwent G test and GM test in serum and bronchoalveolar lavage fluid,and the detection results in the two groups were compared.The diagnostic value of G test and GM test in serum and alveolar lavage fluid was analyzed.Results:The results of serum G test,GM test,alveolar G test and GM test were different between the two groups(P<0.05).Taking results of histopatholog-ical examination as the golden standard,sensitivity,specificity,accuracy,positive predictive value and negative predictive value of serum G test,serum GM test,bronchoalveolar lavage fluid G test and bronchoalveolar lavage fluid GM test in the diagnosis of IPFI were(69.81%,100.00%,84.91%,100.00%,76.81%),(41.51%,100.00%,70.75%,100.00%,63.10%),(100.00%,73.58%,86.79%,79.10%,100.00%)and(77.36%,64.15%,70.75%,68.33%,73.91%),respectively.ROC curves analysis showed that area under the curve(AUC)values of serum G test,serum GM test,bronchoalveolar lavage fluid G test and bronchoalveolar lavage fluid GM test in the diagnosis of pulmonary fungal infection were 0.804,0.862,0.978 and 0.987,all of which had certain discriminatory val-ue for IPFI.Conclusion:G test and GM test in serum and bronchoalveolar lavage fluid all have certain diagnostic value for IPFI.Ac-cording to different thresholds,they have their own advantages and disadvantages in terms of sensitivity and specificity.Clinically,com-prehensive assessment should be conducted based on actual situation and multiple detection results.

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程家亮;龚国忠;代莉;张孝廉;张俊;.血清和肺泡灌洗液G试验、GM试验在侵袭性肺部真菌感染中的诊断价值研究[J].川北医学院学报,2025,40(8):1075-1078.

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  • 在线发布日期: 2025-08-10
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