血清半乳甘露聚糖检测对呼吸系统疾病患者侵袭性肺曲霉病的诊断价值

摘要/Abstract

摘要： 目的评价ELISA试验检测曲霉半乳甘露聚糖(galactomannan, GM)对呼吸系统疾病患者侵袭性肺曲霉病(invasive pulmonary aspergillosis, IPA)的诊断价值。方法采用ELISA方法检测135例（分为确诊IPA患者4例，临床诊断IPA患者20例，拟诊IPA患者48例，非IPA患者63例）可疑IPA患者的306份血清GM抗原，进行受试者工作特征（ROC）曲线分析，估计ROC曲线下面积；通过ROC曲线分析敏感度和特异度的关系，确定合适阈值。结果 IPA组（24例）患者血清GM值（1.37±1.21）明显高于非IPA组患者（63例）血清GM值（0.49±0.18）(F=31.10，P＜0.05)。IPA患者与非IPA患者的GM试验ROC曲线下面积为0.746 (95% CI=0.621～0.872)，经分析取临界值（cut-off值）为0.63，敏感度为66.7%，特异度为73.0%。结论通过ELISA检测GM适用于临床诊断呼吸系统疾病患者IPA的感染，具有一定的诊断价值。

关键词: 侵袭性肺曲霉病, 呼吸道疾病, 甘露聚糖类, 酶联免疫吸附测定

Abstract: Objective To assess the diagnostic value of detecting aspergillus galatomannan (GM) antigen in the patients with invasive pulmonary aspergillosis (IPA). Methods The asepergillus GM antigen in the sera from 135 patients was detected by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic curve (ROC curve) was generated, and the area under the curve was revealed. The sensitivity and the specificity of GM assay were evaluated and the best cut-off value was chosen. Results GM level in the sera from 24 IPA patients （1.37±1.21）was significantly higher than 63 non-IPA patients（0.49±0.18）(F=31.10，P＜0.05). The area under the curve was 0.746 (95% CI=0.621-0.872). When the cut-off value was set at 0.63, the sensitivity and the specificity of GM assay were 66.7% and 73.0% respectively. Conclusion GM assay showed the higher sensitivity and specificity. It is useful for the early diagnosis of IPA.

Key words: Invasive pulmonary aspergillosis, Respiratory tract diseases, Mannans, Enzyme-linked imunosorbent assay

葛伟刘志敏蒋彩花胡华王海英. 血清半乳甘露聚糖检测对呼吸系统疾病患者侵袭性肺曲霉病的诊断价值[J]. 中国防痨杂志, 2012, 34(6): 369-373.

GE Wei, LIU Zhi-min, JIANG Cai-hua, HU Hua, WANG Hai-ying. Evaluation of the galactomannan assays for the diagnosis of invasive pulmonary aspergillosis in the patients with respiratory disease[J]. Chinese Journal of Antituberculosis, 2012, 34(6): 369-373.

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