支气管肺泡灌洗液的半乳甘露聚糖检测在侵袭性肺曲霉病早期诊断中的应用分析.docVIP

支气管肺泡灌洗液的半乳甘露聚糖检测在侵袭性肺曲霉病早期诊断中的应用分析 　　[摘要] 目的 评价支气管肺泡灌洗液中半乳甘露聚糖检测对于侵袭性肺曲霉病早期诊断的临床意义。 方法 通过对90例因肺部感染入院就诊的患者行支气管肺泡灌洗液（BALF）的半乳甘露聚糖（GM）检测，对比分析BALF 及血清GM检测对于侵袭性肺曲霉病的诊断效率。 结果 90例患者中确诊IPA 3例，临床诊断 IPA 12例，拟诊 IPA 9例；以I=0.5作为临界值诊断，BALF及血清GM 检测的敏感度、特异度、阳性预测值和阴性预测值分别为 87.50%、81.82%、63.64% 、94.74%和54.17%、90.91%、68.42%、84. 51%；以I=1.0作为临界值，BALF 及血清GM 检测的敏感度、特异度、阳性预测值和阴性预测值分别为 66.67%、100.00%、100.00%、89.19%和25.00%、100.00%、100.00%、78.57%；BALF和血清GM检测的特异度和阳性预测值均达到100%，但BALF GM检测的敏感度较血清GM检测显著升高（P0.05）。 结论 与血清GM检测相比，BALF GM检测诊断的敏感度、特异度以及阳性/阴性预测值均有所提高，对于IPA的诊断更早、更准确，值得在临床中广泛应用。 　　[关键词] 侵袭性肺曲霉病；支气管肺泡灌洗液；半乳甘露聚糖；早期诊断 　　[中图分类号] R825.6[文献标识码] A[文章编号] 1674-4721（2014）05（b）-0024-04 　　 　　Application and analysis of galactomannan of bronchoalveolar lavage fluid in the early diagnosis of invasive pulmonary aspergillosis 　　LUO Ning TAN Shi-fan CHEN Hui ZHANG Xiong LIU Chuan-yong 　　1．Department of Respiratory Medicine,People′s Hospital of Maoming Cityin Guangdong Province,Maoming 525000,China;2.Department of Internal Medicine of Hematology,People′s Hospital of Maoming Cityin Guangdong Province,Maoming 525000,China;3.Central Laboratory,People′s Hospital of Maoming City in Guangdong Province,Maoming 525000,China 　　[Abstract] Objective To evaluate the clinical influence of galactomannan (GM) detection in bronchoalveolar lavage fluid (BALF) in the diagnosis of invasive pulmonary aspergillosis (IPA). Methods 90 cases with lung infection admitted into the hospital were selected to detect GM in BALF,and then the detection efficiency of both BALF and serum GM for the diagnosis of IPA were analyzed comparatively. Results Among 90 patients enrolled,3 cases were diagnosed as IPA,12 cases were diagnosed clinically as IPA,9 cases were diagnosed suspected as IPA;taking I=0.5 as the critical value of diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value for BALF were 87.50%,81.82%,63.64%,94.74% and those for serum GM were 54.17%,90.91%,68.42%,84.51% respectively;t