―β―D葡聚糖检测于患儿侵袭性肺部真菌感染临床诊断中应用价值.docVIP

(1,3)―β―D葡聚糖检测于患儿侵袭性肺部真菌感染临床诊断中的应用价值 　　[摘要] 目的 讨论于儿童肺部侵袭性真菌感染的临床诊断中血浆（1，3）-β-D葡聚糖检测及支气管肺泡灌洗液的应用价值。方法 整群选取2014年3月―2015年4月间于该院住院治疗的肺部侵蚀性真菌感染患儿33例，作为实验组，选取同期单纯肺炎患儿31例及非肺炎患儿29例记为肺炎组及非肺炎组。将所有选中患儿的支气管肺泡灌洗液（1，3）-β-D葡聚糖检测（G试验）结果进行统计，并与血浆G试验对比，讨论两种方法使用价值。结果 实验组BALF G试验结果（283.12±123.5）pg/mL与血浆G试验结果（99.3±23.2）pg/mL对比优势明显差异有统计学意义（t=3.542，P=0.014）；肺炎组BALF G试验结果（17.4±6.2）pg/mL与血浆G试验结果（11.2±3.8）pg/mL相比，差异无统计学意义（t=-3.708，P=0.803）；非感染组BALF G试验结果（17.4±6.2）与血浆G试验结果（5.6±3.2）相比，差异无统计学意义（t=-2.568，P=0.712）；实验组结果明显高于其它两组，差异有统计学意义（t=4.125，P=0.011）；3组血浆G试验结果相比，试验组明显高于其他两组，差异有统计学意义（t=3.578，P=0.013）。 结论 BALF G试验及血浆G试验均可对肺部侵袭性真菌感染做出明确诊断，且与血浆G试验相比，BALF G试验于肺部侵袭性真菌感染的诊断中更早、更准确，临床价值更高。 　　[关键词] 真菌性；血浆；葡聚糖；支气管肺泡 　　[中图分类号] R726 [文献标识码] A [文章编号] 1674-0742（2015）11（b）-0177-02 　　[Abstract] Objective To discuss the application value of detection （1，3）-β-D-glucan in plasma and that in bronchoalveolar lavage fluid （BALF） in the clinical diagnosis of children with invasive pulmonary fungal infection. Methods 33 children suffering from invasive pulmonary fungal infection hospitalized in this hospital from March 2014 and April 2015 were included and assigned to the experimental group. Other 31 children with simple pneumonia who were treated in this hospital in the same period and were marked as the pneumonia group and 29 non- pneumonia children who were treated in this hospital and were marked as the non-pneumonia group were assigned to the control group. The results of detection of （1，3）-β-D-glucan （G test） in BALF of all the children included in study were recorded and compared with plasma （1，3）-β-D-glucan detection （G test） results. The value of the two methods in the clinical diagnosis of children with invasive pulmonary fungal infection was discussed. Results In the experimental group， the result of BALF G test was superior to the that of plasma G test [（283.12±123.5）pg/mL vs（99.3±23.2）pg/mL]， and the difference was statistically significant，（t=3.542， P=0.014）； in the pneumonia group， no statisticall