Lai Chih Cheng, Hsu Hsiao Leng, Lee Li Na, Hsueh Po Ren
Division of Critical Care Medicine, Department of Emergency, Lotung Poh-Ai Hospital, Yi-Lan, Taiwan.
J Microbiol Immunol Infect. 2007 Apr;40(2):148-53.
This study investigated the diagnostic value of Platelia Aspergillus enzyme immunoassay (EIA) for galactomannan (GM) antigen in patients at risk of invasive aspergillosis (IA), and its association with clinical course and outcome.
A total of 304 blood samples were collected from 189 patients at risk of IA during a 1-year period at a tertiary referral center. Classification of IA was made on the basis of the European Organization for Research and Treatment of Cancer case definitions.
Of the 189 patients, 5 had proven IA, 9 had probable IA, 26 had possible IA, and 149 had no IA. Diagnostic levels of GM were detected in 80% of proven and in 77% of probable IA cases. The overall sensitivity, specificity, and positive and negative predictive values for this assay, using a 1.5 index cut-off value, were 78.6%, 93.9%, 55.0%, and 97.9%, respectively. With the 0.5 index cut-off value, the sensitivity would increase to 100%. A close relationship was found between clinical course and the kinetics of GM indices in survivors.
The Platelia Aspergillus EIA is a useful screening test for the detection of IA. Regular monitoring of the kinetics of GM-EIA indices is a useful predictor of clinical course and outcome.
本研究调查了曲霉半乳甘露聚糖（GM）抗原的普立泰 Aspergillus 酶免疫测定法（EIA）对侵袭性曲霉病（IA）高危患者的诊断价值，及其与临床病程和结局的相关性。
在一家三级转诊中心，于 1 年时间内从 189 例 IA 高危患者中总共采集了 304 份血样。IA 的分类依据欧洲癌症研究与治疗组织的病例定义进行。
189 例患者中，5 例确诊为 IA，9 例可能为 IA，26 例可能有 IA，149 例无 IA。确诊 IA 病例中有 80%检测到 GM 诊断水平，可能 IA 病例中有 77%检测到。使用 1.5 指数截断值时，该检测的总体敏感性、特异性、阳性预测值和阴性预测值分别为 78.6%、93.9%、55.0%和 97.9%。使用 0.5 指数截断值时，敏感性将增至 100%。在幸存者中发现临床病程与 GM 指数动力学之间存在密切关系。
普立泰 Aspergillus EIA 是检测 IA 的一项有用的筛查试验。定期监测 GM - EIA 指数动力学是临床病程和结局的一项有用预测指标。
