支气管肺泡灌洗液中的半乳甘露聚糖用于非中性粒细胞减少患者侵袭性肺曲霉病的诊断
Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients.
作者信息
Zhuang Qidong, Ma Hongying, Zhang Yun, Chen Lei, Wang Li, Zheng Lin, Deng Zaichun, Chen Zhongbo
机构信息
Department of Pulmonology, The Affiliated Hospital of Ningbo University, 247 Renmin Road, Ningbo, Zhejiang 315020, China.
Department of Microbiology, The Affiliated Hospital of Ningbo University, 247 Renmin Road, Ningbo, Zhejiang 315020, China.
出版信息
Can Respir J. 2017;2017:3685261. doi: 10.1155/2017/3685261. Epub 2017 Nov 13.
BACKGROUND
We evaluated the utility of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) in nonneutropenic patients.
METHODS
A total of 183 patients were included in the final analysis. Bronchoscopies and the detection of GM in BALF were all performed on them.
RESULTS
Ten cases of IPA were diagnosed. ROC data demonstrated that, for diagnosing IPA, an optimal cutoff value for GM in BALF of 0.76 yielded a sensitivity of 100.0% and a specificity of 76.2%. Symptoms and radiological findings had no significant difference between proven or probable IPA group and non-IPA group. In our case-control analysis, although nine patients with false-positive results received treatment with Piperacillin/tazobactam, there was no significant difference between case and control group.
CONCLUSIONS
BALF GM detection is a valuable adjunctive diagnostic tool. Our retrospective study suggests that the optimal value of GM detection in BALF is 0.76 in nonneutropenic patients.
背景
我们评估了支气管肺泡灌洗液（BALF）中的半乳甘露聚糖（GM）在非中性粒细胞减少患者侵袭性肺曲霉病（IPA）诊断中的应用价值。
方法
共有183例患者纳入最终分析。对他们均进行了支气管镜检查及BALF中GM的检测。
结果
确诊IPA 10例。ROC数据显示，对于IPA诊断，BALF中GM的最佳截断值为0.76时，敏感性为100.0%，特异性为76.2%。确诊或疑似IPA组与非IPA组在症状和影像学表现上无显著差异。在我们的病例对照分析中，尽管9例假阳性结果患者接受了哌拉西林/他唑巴坦治疗，但病例组与对照组之间无显著差异。
结论
BALF中GM检测是一种有价值的辅助诊断工具。我们的回顾性研究表明，非中性粒细胞减少患者BALF中GM检测的最佳值为0.76。
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