血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测对不同类型真菌性鼻窦炎诊断的临床意义
|
摘要
目的探讨血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测对不同类型真菌性鼻窦炎诊断的临床意义。方法选取本院2014年8月～2016年8月122例不同类型真菌性鼻窦炎患者:60例侵袭性真菌性鼻窦炎(A组)和62例非侵袭性真菌性鼻窦炎(B组);健康人60例作为对照组,采用酶联免疫吸附法测定两组患者的免疫球蛋白指标(IgG、IgA、IgM),采用动态浊度法检测血浆1,3-β-D葡聚糖水平,观察2组患者的血浆1,3-β-D葡聚糖、IgG、IgA、IgM水平,判断血浆1,3-β-D葡聚糖检测、血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测不同类型真菌性鼻窦炎的的敏感性、特异性、阳性预测值及阴性预测值。结果 A组的1,3-β-D葡聚糖水平和IgG、IgA、IgM水平明显高于B组和对照组,具有统计学意义(P<0.05);血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测的不同类型真菌性鼻窦炎的的敏感性、特异性、阳性预测值及阴性预测值具有明显差异(P<0.05);血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测的敏感性、特异性、阳性预测值及阴性预测值明显高于血浆1,3-β-D葡聚糖检测(P<0.05)。结论血浆1,3-β-D葡聚糖联合免疫球蛋白指标检测可以应用于不同类型真菌性鼻窦炎诊断,但是对侵袭性真菌性鼻窦炎的诊断价值更高。
Objective To study the clinical significance of the detection of plasma 1,3-β-D dextran combined with immunoglobulin in the diagnosis of different types of fungal rhino sinusitis.Methods From August 2014 to August 2016,122 cases of different types of fungal rhino sinusitis patients(60 cases of invasive fungal rhino sinusitis(A group) and 62 cases of non invasive fungal rhino sinusitis(B group)),and 60 healthy people as control group.Two groups of patients with immunoglobulin index were detected by enzyme linked immunosorbent assay(IgG IgA,IgM),plasma 1,3-β-D glucan was detected by the dynamic turbidimetric assay,the sensitivity,specificity,positive predictive value and negative predictive value of plasma 1,3-β-D glucan detection,plasma 1,3-β-D dextran combined with immunoglobulin index detection of different types of fungal rhino sinusitis were determined.Results 1,3-β-D glucan levels and IgG,IgA,IgM levels of A group were significantly higher than the group B and control group,with statistical significance(P<0.05);sensitivity,specificity,positive predictive value and negative value of the detection of plasma 1,3-β-D glucan combined with immunoglobulin index of different types of fungal rhino sinusitis had significant difference(P<0.05);sensitivity,specificity,positive predictive value and negative predictive value of detection of plasma1,3-β-D glucan combined with immunoglobulin index was significantly higher than the plasma1,3-β-D glucan assay(P<0.05).Conclusion The detection of 1,3-β-D glucan combined with immunoglobulin can be used in the diagnosis of different types of fungal rhino sinusitis,but it is more valuable in the diagnosis of invasive fungal rhino sinusitis.
Objective To study the clinical significance of the detection of plasma 1,3-β-D dextran combined with immunoglobulin in the diagnosis of different types of fungal rhino sinusitis.Methods From August 2014 to August 2016,122 cases of different types of fungal rhino sinusitis patients(60 cases of invasive fungal rhino sinusitis(A group) and 62 cases of non invasive fungal rhino sinusitis(B group)),and 60 healthy people as control group.Two groups of patients with immunoglobulin index were detected by enzyme linked immunosorbent assay(IgG IgA,IgM),plasma 1,3-β-D glucan was detected by the dynamic turbidimetric assay,the sensitivity,specificity,positive predictive value and negative predictive value of plasma 1,3-β-D glucan detection,plasma 1,3-β-D dextran combined with immunoglobulin index detection of different types of fungal rhino sinusitis were determined.Results 1,3-β-D glucan levels and IgG,IgA,IgM levels of A group were significantly higher than the group B and control group,with statistical significance(P<0.05);sensitivity,specificity,positive predictive value and negative value of the detection of plasma 1,3-β-D glucan combined with immunoglobulin index of different types of fungal rhino sinusitis had significant difference(P<0.05);sensitivity,specificity,positive predictive value and negative predictive value of detection of plasma1,3-β-D glucan combined with immunoglobulin index was significantly higher than the plasma1,3-β-D glucan assay(P<0.05).Conclusion The detection of 1,3-β-D glucan combined with immunoglobulin can be used in the diagnosis of different types of fungal rhino sinusitis,but it is more valuable in the diagnosis of invasive fungal rhino sinusitis.
引文
[1]于婷,蔡彤,黄清泉.1,3-β-D葡聚糖定量测定在真菌感染诊断中的研究进展[J].国际检验医学杂志,2013,34(2):3186-3188.
[2]Jaijakul S,Vazquez JA,Swanson RN,et al.(1,3)-β-D Glucan as a prognostic marker of treatment response in invasive candidiasis[J].Clin Infect Dis,2012,55(4):521-526.
[3]温冬华,刘钰华,谭坚,等.血浆中葡聚糖动态检测在侵袭性真菌感染的诊断和药物疗效评价中的价值[J].中国药事,2016,30(11):1132-1135.
[4]袁飞,贺松,秦进,等.(1,3)-β-D葡聚糖检测对侵袭性真菌感染诊断价值的系统评价[J].中国实验诊断学,2012,16(12):2275-2279.
[5]Sulahian A,Porcher R,Bergeron A,et al.Use and limits of(1-3)-β-D-glucan assay(Fungitell),compared to galactomannan determination(Platelia Aspergillus),for diagnosis of invasive aspergillosis[J].J Clin Microbiol,2014,52(7):2328-2333.
[6]蔡文莹,鲁长明,席丽艳.血清(1-3)-β-D-葡聚糖检测对深部真菌感染辅助诊断的临床价值[J].皮肤性病诊疗学杂志,2015,22(3):175-178.
[7]Senn L,Robinson JO,Schmidt S,et al.1,3-Beta-D-glucan antigenemia for early diagnosis of invasive fungal infections in neutropenic patients with acute leukemia[J].Clin Infect Dis,2012,46(6):878-885.
[8]童彤,沈继录,徐元宏,等.G试验联合GM试验对恶性血液病患者伴侵袭性真菌病的诊断价值研究[J].中国微生态学杂志,2016,28(10):1152-1157.
[9]焦莉莉,周树生,常虹,等.血浆1,3-β-D葡聚糖检测在老年人侵袭性真菌病诊疗中的价值[J].中国临床保健杂志,2015,18(1):41-44.
[10]Lamoth F,Cruciani M,Mengoli C,et al.b-Glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies:a systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia(ECIL-3)[J].Clin Infect Dis,2012,54(5):633-643.
[11]张欣,喻华.血清1,3-β-D葡聚糖检测在侵袭性真菌感染诊断中的价值[J].检验医学与临床,2016,13(17):2451-2452.
[12]Karageorgopoulos DE,Qu JM,Korbila IP,et al.Accuracy of bD-glucan for the diagnosis of Pneumocystis jirovecii pneumonia:a meta-analysis[J].Clin Microbiol Infect,2013,19(1):39-49.
[13]崔建娇,史际华,陈冬梅,等.1,3-β-D葡聚糖在真菌感染诊断及治疗中的应用[J].中华医院感染学杂志,2014,24(13):4155-4157.
[14]Acosta J,Catalan M,Del Palacio Perez Medel A,et al.Prospetive study in critically ill non-neutropenic patients:diagnostic potentional of 1,3-β-d-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease[J].Eur J Clin Microbiol Infect Dis,2012,31(5):721-731.
[15]殷潇娴,王玉月,张淑瑛,等.血浆(1,3)-β-D葡聚糖检测对侵袭性真菌感染的诊断价值[J].国际检验医学杂志,2014,35(16):2185-2187.
[2]Jaijakul S,Vazquez JA,Swanson RN,et al.(1,3)-β-D Glucan as a prognostic marker of treatment response in invasive candidiasis[J].Clin Infect Dis,2012,55(4):521-526.
[3]温冬华,刘钰华,谭坚,等.血浆中葡聚糖动态检测在侵袭性真菌感染的诊断和药物疗效评价中的价值[J].中国药事,2016,30(11):1132-1135.
[4]袁飞,贺松,秦进,等.(1,3)-β-D葡聚糖检测对侵袭性真菌感染诊断价值的系统评价[J].中国实验诊断学,2012,16(12):2275-2279.
[5]Sulahian A,Porcher R,Bergeron A,et al.Use and limits of(1-3)-β-D-glucan assay(Fungitell),compared to galactomannan determination(Platelia Aspergillus),for diagnosis of invasive aspergillosis[J].J Clin Microbiol,2014,52(7):2328-2333.
[6]蔡文莹,鲁长明,席丽艳.血清(1-3)-β-D-葡聚糖检测对深部真菌感染辅助诊断的临床价值[J].皮肤性病诊疗学杂志,2015,22(3):175-178.
[7]Senn L,Robinson JO,Schmidt S,et al.1,3-Beta-D-glucan antigenemia for early diagnosis of invasive fungal infections in neutropenic patients with acute leukemia[J].Clin Infect Dis,2012,46(6):878-885.
[8]童彤,沈继录,徐元宏,等.G试验联合GM试验对恶性血液病患者伴侵袭性真菌病的诊断价值研究[J].中国微生态学杂志,2016,28(10):1152-1157.
[9]焦莉莉,周树生,常虹,等.血浆1,3-β-D葡聚糖检测在老年人侵袭性真菌病诊疗中的价值[J].中国临床保健杂志,2015,18(1):41-44.
[10]Lamoth F,Cruciani M,Mengoli C,et al.b-Glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies:a systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia(ECIL-3)[J].Clin Infect Dis,2012,54(5):633-643.
[11]张欣,喻华.血清1,3-β-D葡聚糖检测在侵袭性真菌感染诊断中的价值[J].检验医学与临床,2016,13(17):2451-2452.
[12]Karageorgopoulos DE,Qu JM,Korbila IP,et al.Accuracy of bD-glucan for the diagnosis of Pneumocystis jirovecii pneumonia:a meta-analysis[J].Clin Microbiol Infect,2013,19(1):39-49.
[13]崔建娇,史际华,陈冬梅,等.1,3-β-D葡聚糖在真菌感染诊断及治疗中的应用[J].中华医院感染学杂志,2014,24(13):4155-4157.
[14]Acosta J,Catalan M,Del Palacio Perez Medel A,et al.Prospetive study in critically ill non-neutropenic patients:diagnostic potentional of 1,3-β-d-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease[J].Eur J Clin Microbiol Infect Dis,2012,31(5):721-731.
[15]殷潇娴,王玉月,张淑瑛,等.血浆(1,3)-β-D葡聚糖检测对侵袭性真菌感染的诊断价值[J].国际检验医学杂志,2014,35(16):2185-2187.