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血清曲霉菌半乳甘露聚糖抗原检测在侵袭性肺部曲霉菌感染治疗中的应用
刘行仁,邓菲,冯静,邹俊,杨阳
0
(四川省医学科学院·四川省人民医院,呼吸内科;四川省医学科学院·四川省人民医院,肾脏内科;四川省医学科学院·四川省人民医院,中医科)
摘要:
【摘要】目的 评价血清曲霉菌半乳甘露聚糖(GM)抗原检测在侵袭性肺部曲霉菌感染治疗中的应用价值。方法 采取单中心回顾性研究,在四川省人民医院呼吸内科及内科重症监护室内,随机选择通过肺部痰培养确诊为曲霉菌感染的患者30例(研究组),白色念珠菌感染的患者30例(对照A组),无真菌感染的患者30例(对照B组),分别在治疗初期(0~1周)、中期(2~4周)和治疗结束时(4~6周)检测血清曲霉菌半乳甘露聚糖抗原。比较三组患者治疗前后各组自身及三组之间检测结果变化。结果 研究组中治疗有效的患者治疗前的GM检验结果明显高于治疗后(P=0.000,t=11.784),而治疗无效的患者治疗前后GM检验结果比较无明显差异(P=0.335,t=0.449);三组治疗有效患者同期的GM检验结果比较发现,在治疗初期,研究组的GM检验结果明显高于另外两组(P<0.05),而对照两组间的GM检验结果并没有明显差异(P>0.05);在治疗结束时,三组治疗有效的患者间的GM检验结果没有明显差异(P>0.05)。结论 血清曲霉菌半乳甘露聚糖抗原检验在侵袭性肺曲霉菌病(IPA)患者诊治中,能有效帮助早期诊断和在治疗过程中评估患者恢复情况,具有良好的应用价值,值得在临床诊治中进一步推广。
关键词:  GM抗原检测  侵袭性肺部曲霉菌感染  应用价值
DOI:
基金项目:四川省卫计委科研课题(110137)
Serum galactomannan antigen detection in the treatment of invasive pulmonary aspergillosis
LIU xingren,DENG Fei,FENG Jing,ZHOU Jun,YANG Yang
(Department of Respiratory Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospita;Department of Nephrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital;Department of Traditional Chinese Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospita)
Abstract:
【Abstract】Objective This study aimed to evaluate the applicative value of serum galactomannan antigen detection (GM test) in therapy for invasive pulmonary fungal infection. Methods We conducted this singlecenter and retrospective study to examine the characteristics of serum GM test in patients confirmed pulmonary fungal infection by pulmonary phlegm culture. These patients were randomly selected from Department of respiratory and ICU in the Sichuan Provincial People's Hospital. There were 30 patients with Aspergillus infection in the study group, 30 patients with Candida albicans infection in the control group A and 30 patients with no fungal infection in the control group B. We detected the level of serum galactomannan antigen respectively at the beginning(01 weeks), the middle (24 weeks) and the end(46 weeks) of the period of therapy. Then evaluated the applicative value of serum galactomannan antigen detection in therapy for invasive pulmonary fungal infection.Results The results of GM test in patients with effective treatment in the study group before treatment is obviously higher than that after treatment (P= 0.000, t=11.784). However, there was no significance in the results of GM tests upon refractory patients of the study group between before and after treatment(P=0.335, t=0.449). According to the GM test among patients with effective therapy in three groups at the same period of treatment, the results of GM test in the study group were significantly higher than that of the other groups(P<0.05), whereas there was no significant difference about GM test between the control group A and the control group B(P > 0.05). At the end of treatment, there was no significant difference among all the three groups about GM test in patients with effective therapy (P>0.05).Conclusion Our study revealed that GM test could effectively improve early diagnosis and assessment of prognosis to patients with IPA treatment upon pulmonary invasive aspergillosis. There is great value for further clinical application of GM test.
Key words:  Serum Galactomannan  Invasive pulmonary aspergillosis  Clinical application

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