艾滋病患者肺孢子菌肺炎治疗后血清β-D-葡聚糖的动力学
Kinetics of serum β-D-glucan after Pneumocystis pneumonia treatment in patients with AIDS.
作者信息
Koga Michiko, Koibuchi Tomohiko, Kikuchi Tadashi, Nakamura Hitomi, Miura Toshiyuki, Iwamoto Aikichi, Fujii Takeshi
机构信息
International Research Center for Infectious Diseases, the Institute of Medical Science, the University of Tokyo, Japan.
出版信息
Intern Med. 2011;50(13):1397-401. doi: 10.2169/internalmedicine.50.5296. Epub 2011 Jul 1.
OBJECTIVE
Serum β-D-glucan has been demonstrated as a reliable, adjunct diagnostic marker for PCP, but its kinetics after PCP treatment are poorly understood. To evaluate the correlation between the levels of β-D-glucan and the clinical response, we investigated the individual transition of serum β-D-glucan levels after the initiation of PCP treatment.
METHODS
Retrospective study
PATIENTS
Seventeen PCP patients with AIDS who were admitted to our hospital were analyzed.
RESULTS
All subjects showed the serum β-D-glucan levels above the cut-off value, and the median level was 224 pg/mL [IQR: 78-597] at the time of PCP diagnosis. There were no correlations between serum β-D-glucan levels and CRP, LDH, or AaDO(2) at room air. Although there was a downward trend in serum β-D-glucan level as PCP treatment was initiated, a significant number of subjects showed a marked increase in the serum β-D-glucan levels despite their evident clinical improvement.
CONCLUSION
The serum β-D-glucan level does not reflect the severity and prognosis of PCP infection, and thus it may not be suitable for monitoring the response to treatment.
目的
血清β-D-葡聚糖已被证明是一种用于肺孢子菌肺炎（PCP）的可靠辅助诊断标志物，但其在PCP治疗后的动力学变化尚不清楚。为了评估β-D-葡聚糖水平与临床反应之间的相关性，我们研究了PCP治疗开始后血清β-D-葡聚糖水平的个体变化情况。
方法
回顾性研究
患者
对我院收治的17例艾滋病合并PCP患者进行分析。
结果
所有受试者血清β-D-葡聚糖水平均高于临界值，PCP诊断时的中位数水平为224 pg/mL[四分位间距：78 - 597]。血清β-D-葡聚糖水平与CRP、LDH或室内空气下的肺泡动脉氧分压差（AaDO₂）之间无相关性。尽管在开始PCP治疗后血清β-D-葡聚糖水平呈下降趋势，但仍有相当数量的受试者尽管临床明显改善，其血清β-D-葡聚糖水平却显著升高。
结论
血清β-D-葡聚糖水平不能反映PCP感染的严重程度和预后，因此可能不适用于监测治疗反应。
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