摘要
目的:探讨血清及肺泡灌洗液半乳甘露聚糖抗原(GM)酶联免疫吸附试验(ELISA)检测方法在早期免疫功能低下患者合并肺曲霉菌感染诊断的可行性和指导临床治疗的价值。方法:采用ELISA检测临床确诊或拟诊的侵袭性肺曲霉菌病患者血清及肺泡灌洗液曲霉菌GM抗原的水平后,将其中32例患者随机分为A组(10例)、B组(14例),C组(8例)均给予伏立康唑静脉与口服序贯治疗,在0、8、12周时评价临床疗效。结果:临床确诊或拟诊的侵袭性肺曲霉菌病32例,均给予伏立康唑治疗,治疗8周及12周复查血清GM及肺泡灌洗液GM,A、B两组治疗前后GM值有明显变化,提示有意义,特别是B组灌洗液与血清对比,差异有统计学意义。结论:曲霉菌血清GM抗原ELISA检测可用于早期临床诊断侵袭性肺曲霉菌病;联合肺泡灌洗液检测可提高阳性率,以cut-off≥0.5为阳性折点,给予先发抗真菌治疗有重要意义;定期连续观察血及肺泡灌洗液GM可用于肺曲霉菌治疗的病情监测,同时联合胸部CT、痰培养可用于抗真菌治疗的疗效评价。
Objective To explore the utility of serum and alveolar lavage fluid detecting GM antigen with ELISA for diagnosing and the early treatment of invasive pulmonary aspergillosis（IPA） in immunodepresion patients.Besides,the possibility of guiding therapy clinically.Methods ELISA was performed to serially for galactomannan（GM） in 32 pulmonary fungal infection patients.Patients were randomly divided into three groups（group,A（n = 10）,B（n = 14） and C（n = 8）,according to investigate serially for galactomannan（GM）.all of cases administered with intravenous voriconazole followed by voriconazole tablet sequential therapy.The clinical curative efficacy were investigated in 0,8,12 weeks.Results 32 cases were administered with intravenous voriconazole followed by voriconazole tablet sequential.Three groups had high overall effective rates,and had significant differences in Group A and B.（P 0.05）.Conclusion The aspergillus ELISA may use to diagnose the early treating invasive pulmonary aspergillosis（IPA） in immunodepresion patients.Patients with a positive test result should deserve preemptive antifungal therapy in invasive pulmonary aspergillosis（IPA） with immunocompromisie.To serially observe the galactomannan（GM）,sputum aspergillus cultures and chest computed tomography may play an important role in IPA.
出处
《放射免疫学杂志》
CAS
2013年第4期478-481,共4页
Journal of Radioimmanology
