摘要
目的:探讨针对感染的肺组织局部进行支气管肺泡灌洗术得到支气管肺泡灌洗液(BALF)进行半乳甘露聚糖(GM)检测是否能协助提高非粒细胞缺乏的患者并侵袭性肺曲霉病(IPA)的诊断效率,并了解其最佳GM界值。方法:收集并分析2011年1月至2013年12月在呼吸科内镜中心检查考虑IPA可能并行BALF GM检测的患者173例。按照国内外诊断标准,将病例分为4组,IPA组(n=23),肺结核组(n=11),细菌性肺炎组(n=90),非感染组(n=49)。采用ELISA方法测定血清及BALF GM。用统计学方法了解BALF GM检测在非粒细胞缺乏的患者并发IPA中的诊断价值。结果:在非粒细胞缺乏的患者并发IPA的诊断中,与非IPA患者相比,IPA患者的BALF GM检测数值高,组间差异有统计学意义:与血清GM检测相比,BALF GM检测的IPA诊断效率高。ROC曲线分析发现,当BALF GM检测界值为≥0.95时,IPA的诊断效率最高。结论:BALF GM检测有利于非粒细胞缺乏患者并IPA的早期鉴别与诊断。同时研究发现BALF GM值最佳界值为≥0.95。
Objective To study infection of the lung tissue by bronchoalveolar lavage for BALF and explore whether GM can help improve the he diagnosis efficiency in patients without granulocyte deficiency with IPA,and find the threshold of GM values.Methods Between January 2011 and December 2011,173 cases of patients were considered possible invasive pulmonary aspergillosis in parallel BALF GM detection in the center of the respiratory endoscopic examination..According to the diagnostic criteria at home and abroad,all the cases were divided into four groups,including group of IPA,group of tuberculosis,group of bacterial pneumonia and group of non-infection.Using ELISA method for determination of serum and BALF GM.The diagnostic value was made by statistical methods in BALF GM detection without patients of granulocyte deficiency with IPA.Results There were 11 cases in the group of IPA,23 cases in the group of tuberculosis,90 cases in the group of bacterial pneumonia and 49 cases in the group of non-infection.In patients without granulocyte deficiency with IPA,BALF GM value was higher comparing with the patients without IPA.There were significant difference between the two groups;Comparing the GM value in the serum,the detection of BALF GM was higher in IPA.ROC curve analysis found that when the BALF GM test value was 0.95 or higher,there was highest possible with IPA.Conclusion BALF GM testing is beneficial to patients of invasive pulmonary aspergillosis without granulocyte deficiency in early identification with IPA.This study found that BALF GM best value is 0.95 or higher.
出处
《实用医学杂志》
CAS
北大核心
2016年第1期130-133,共4页
The Journal of Practical Medicine
关键词
支气管肺泡灌洗液
半乳甘露聚糖抗原
侵袭性肺曲霉病
非粒细胞缺乏
Bronchoalveolar lavage fluid
Galactomannan antigen
Invasive pulmonary aspergillosis Deficiency of granulocyte.
