G试验在深部真菌感染快速诊断中的临床价值探讨

Clinical value of G test in rapid diagnosis of deep fungal infection

摘要:

目的通过分析血浆（1，3）-β-D 葡聚糖（G 试验）、真菌培养结果与真菌感染的相关性，探讨G 试验在深部真菌感染（DFI）快速诊断中的临床价值。方法选择2013 年9 月-2016 年1 月，861 例疑诊为DFI 的患者进行G 试验及真菌培养，分析G 试验与真菌培养对DFI 的诊断效率。结果在疑诊为DFI 861 例患者中，临床诊断为DFI 组181 例，非DFI 组680 例。G 试验与真菌培养阳性率分别为29.27%（252/861）和21.37%（184/861），两者比较，差异有统计学意义（P <0.05）。G试验诊断DFI 的敏感性、特异性、阳性预测值、阴性预测值及准确度分别为89.50%、86.76%、64.29%、96.88%和87.34%；真菌培养诊断DFI 的敏感性、特异性、阳性预测值、阴性预测值及准确度分别为59.12%、88.68%、58.15%、89.07%和82.46%。结论G 试验在快速、早期诊断DFI中有重要临床价值。

Abstract:

Objective To analyze the correlations of plasma (1, 3)-beta-D glucan (G test) and fungal culture results with fungal infection, and explore the clinical value of G test in rapid diagnosis of deep fungal infection(DFI). Methods From September 2013 to January 2016, 861 cases of patients were suspected as DFI. They underwent G trials and fungal culture. The efficiency of G test and fungal culture in diagnosis of DFI was analyzed. Results In the 861 patients suspected as DFI, 181 cases were clinically diagnosed with DFI, 680 cases were non-DFI. The positive rates of G test and fungal culture were 29.27% (252/861) and 21.37% (184/861), the difference was statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of G test in diagnosis of DFI were 89.50%, 86.76%, 64.29%, 96.88% and 87.34% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of fungal culture in diagnosis of DFI were 59.12%, 88.68%, 58.15%, 89.07% and 82.46% respectively. Conclusions G test has important clinical value in fast and early diagnosis of DFI.