血清和支气管肺泡灌洗液半乳甘露聚糖检测对非中性粒细胞减少症患者侵袭性肺曲霉病的诊断价值。
Diagnostic value of galactomannan in serum and bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in non-neutropenic patients.
机构信息
The Second Xiangya Hospital of Central South University, Changsha, China.
The Second Xiangya Hospital of Central South University, Changsha, China.
出版信息
Diagn Microbiol Infect Dis. 2021 Apr;99(4):115274. doi: 10.1016/j.diagmicrobio.2020.115274. Epub 2020 Nov 20.
OBJECTIVE
To evaluate the diagnostic performance of galactomannan (GM) detection in serum and bronchoalveolar lavage fluid (BALF) for invasive pulmonary aspergillosis (IPA) in non-neutropenic patients.
METHODS
A total of 291 non-neutropenic patients in the Second Xiangya Hospital of Central South University were included. According to the 2019 EORTC/MSG guidelines, all cases were divided into an IPA group (n = 24) and a non-IPA group (n = 267). Receiver operating characteristic (ROC) curves were drawn to compare the diagnostic efficiency of GM detection in BALF and serum.
RESULTS
According to the receiver operating characteristic curves of BALF and serum GM, the areas under the curve were 0.961 and 0.699, respectively. The optimal BALF GM detection was found when the cutoff value was set to 0.87, whereas the sensitivity and specificity were 91.7% and 92.5%, respectively.
CONCLUSIONS
BALF GM detection is more sensitive than serum GM detection for diagnosing IPA, and the optimal cutoff value for BALF GM is 0.87.
目的
评估血清和支气管肺泡灌洗液（BALF）中半乳甘露聚糖（GM）检测对非中性粒细胞减少症患者侵袭性肺曲霉病（IPA）的诊断性能。
方法
共纳入中南大学湘雅二医院 291 例非中性粒细胞减少症患者。根据 2019 年 EORTC/MSG 指南，所有病例分为 IPA 组（n=24）和非 IPA 组（n=267）。绘制受试者工作特征（ROC）曲线比较 BALF 和血清 GM 检测的诊断效率。
结果
根据 BALF 和血清 GM 的受试者工作特征曲线，曲线下面积分别为 0.961 和 0.699。当截断值设置为 0.87 时，BALF GM 的最佳检测结果为 91.7%的灵敏度和 92.5%的特异性。
结论
BALF GM 检测比血清 GM 检测对 IPA 的诊断更敏感，BALF GM 的最佳截断值为 0.87。
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