论文_血浆（1_3）_β_D_葡聚糖对深部真菌感染诊断研究.docVIP

血浆（1-3）-β-D-葡聚糖对深部真菌感染诊断的研究 摘要：目的：观察血浆（1-3）-β-D-葡聚糖对深部真菌感染诊断的作用。方法：将2005年8月至2006年6月北京友谊医院患者145例（标本182份）分为深部真菌感染组和无深部真菌感染组, 分析比较两组葡聚糖水平；使用ROC曲线确定最佳临界值。结果：深部真菌感染组的葡聚糖水平64.7±86.0（25.5）pg/ml明显高于对照组6. 3±21.0（0.0）pg/ml（P0.001）；血浆葡聚糖用于诊断深部真菌感染的ROC曲线下面积为0.887（95%的置信区间为0.795-0.979），使用临界值13.7pg/ml 诊断深部真菌感染的敏感度、特异度、阳性预测值和阴性预测值分别为88.9%、90.2%、50.0%和98.7%；Kappa值0.588（P0.05）。结论：血浆葡聚糖水平可用于诊断深部真菌感染，本研究使用GKT-5M Set动态真菌检测试剂盒检测血浆葡聚糖水平诊断深部真菌感染的最佳临界值为13.7pg/ml，使用此临界值对深部真菌感染进行诊断的一致性较好。 关键词：深部真菌感染；诊断；(1-3）-β-D-葡聚糖；ROC曲线 Evaluation about diagnosis of invasive fungal infection with (1-3)-β-D-glucan ZHAO Yong, WANG Hong , REN Aimin , ZHANG Shuwen, ZHANG Lixia. Beijing Capital University of Medical Sciences Affiliated Beijing Friendship Hospital , Beijing 100050 , China Abstract: Objective: To evaluate the diagnosis of invasive fungal infection with (1-3)-β-D-glucan(BG). Methods: 145 patients from Beijing Friendship Hospital were divided into two groups according to whether or not diagnosed as invasive fungal infection. Level of (1-3)-β-D-glucan of two groups were compared. Optimal cut-off value was established with ROC curve. Results: Patients diagnosed as invasive fungal infection have a higher level of BG than the control group. (P value 0.001) Area under curve(AUC) was 0.887 (95% confidence interval between 0.795 and 0.979) when level of BG was used to diagnose invasive fungal infection. The sensitivity, specificity, and positive and negative predictive values for BG were 88.9%、90.2%、50.0% and 98.7%, respectively, with Kappa value of 0.588. Conclusion: Level of BG could be used for diagnosis of invasive fungal infection. Optimal cut-off value of plasma BG with GKT-5M Set for diagnosis of invasive fungal infection should be 13.7 pg/ml and, with this cut-off value, agreement of evaluation of BG and criterion of invasive fungal infection for diagnosis of invasive fungal infection was good. Key words: invasive fungal infection; （1-3）-β-D-glucan; diagnosis; ROC curve 随着免疫抑制患者的增多，临床中发生深部真菌感染的机