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定量特异性IgG抗体检测在非中性粒细胞减少侵袭性肺曲霉病诊断中的价值评估

Value Evaluation of Quantitative -Specific IgG Antibody Test in the Diagnosis of Non-neutropenic Invasive Pulmonary Aspergillosis.

作者信息

Sheng Lingyan, Jiang Wenhong, Yao Yake, Zhou Jianying, Zhou Hua

机构信息

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.

Department of Respiratory and Critical Care Medicine, Jiangshan People Hospital, Quzhou, 324110, People's Republic of China.

出版信息

Infect Drug Resist. 2024 May 23;17:2043-2052. doi: 10.2147/IDR.S460513. eCollection 2024.

Abstract

BACKGROUND

The role of -specific IgG antibody test in the diagnosis of non-neutropenic invasive pulmonary aspergillosis (IPA) is still uncertain, and related studies are also limited.

PURPOSE

This study aims to evaluate the quantitative test value of -specific IgG antibody in non-neutropenic IPA, which could provide additional evidence for related clinical diagnosis.

METHODS

This prospective study collected clinical data of suspected IPA patients from January, 2020 to December, 2022, and patients were divided into two groups, IPA and non-IPA. The study analyzed clinical characteristics and diagnostic value of -specific IgG antibody test, using the receiver operating characteristic (ROC) curve to evaluate diagnostic efficacy.

RESULTS

The study enrolled 59 IPA cases and 68 non-IPA cases, the average admission age of IPA group was 63.2±9.6 (33-79), and the gender ratio (male:female) of IPA group was 42:17. The proportion of patients with history of smoking and COPD were higher in IPA group (59.3% vs 39.7%, =0.027; 33.9% vs 14.7%, =0.011, respectively). The level of -specific IgG antibody in IPA group was significantly higher than non-IPA group (202.1±167.0 vs 62.6±58.0, <0.001). The area under the ROC curve was 0.799 (95%CI: 0.718, 0.865 <0.001), and the cut-off with best diagnostic efficacy was 91 AU/mL.

CONCLUSION

Immunological test plays an important role in the diagnosis of pulmonary aspergillosis, and -specific IgG antibody test has the good diagnostic value in non-neutropenic IPA.

摘要

背景

特异性IgG抗体检测在非中性粒细胞减少的侵袭性肺曲霉病(IPA)诊断中的作用仍不明确,相关研究也较为有限。

目的

本研究旨在评估特异性IgG抗体在非中性粒细胞减少的IPA中的定量检测价值,为相关临床诊断提供更多依据。

方法

本前瞻性研究收集了2020年1月至2022年12月疑似IPA患者的临床资料,将患者分为IPA组和非IPA组。分析特异性IgG抗体检测的临床特征及诊断价值,采用受试者工作特征(ROC)曲线评估诊断效能。

结果

本研究纳入59例IPA病例和68例非IPA病例,IPA组平均入院年龄为63.2±9.6(33 - 79岁),IPA组性别比(男∶女)为42∶17。IPA组吸烟史和慢性阻塞性肺疾病(COPD)患者比例更高(分别为59.3%对39.7%,P = 0.027;33.9%对14.7%,P = 0.011)。IPA组特异性IgG抗体水平显著高于非IPA组(202.1±167.0对62.6±58.0,P<0.001)。ROC曲线下面积为0.799(95%CI:0.718,0.865,P<0.001),诊断效能最佳的截断值为91 AU/mL。

结论

免疫学检测在肺曲霉病诊断中起重要作用,特异性IgG抗体检测在非中性粒细胞减少的IPA中具有良好诊断价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b8c/11129758/575053578c7d/IDR-17-2043-g0001.jpg

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