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目的评价1,3-β-D葡聚糖(BG)检测对侵袭性真菌感染(IFI)早期诊断和疗效监测价值。方法应用MB-80微生物动态快速检测系统及GKT-5M set动态真菌检测试剂盒定量检测血浆中BG的含量。结果以50 pg/mL为阳性界值,BG检测的敏感性为72.5%,特异性91.4%,阳性预测值90.6%,阴性预测值74.4%。以20 pg/mL为阳性界值,敏感性为87.5%,特异性88.6%,阳性预测值89.7%,阴性预测值86.1%。连续监测时BG可早于真菌培养方法1～10 d预测真菌感染。在BG阳性患者中,对20例患者进行抗真菌治疗,19例有效,1例无效死亡。抗真菌治疗前BG水平呈缓慢上升趋势,保持在较高水平,抗真菌治疗有效患者的BG含量呈下降趋势,无效死亡患者呈上升趋势。结论血浆BG浓度对血液病和恶性肿瘤患者IFI早期诊断和疗效评价有重要价值。
Objective To evaluate the value of 1,3-β-D-glucan (BG) in the early diagnosis and treatment of invasive fungal infection (IFI). Methods MB-80 microbial rapid detection system and GKT-5M set dynamic fungal detection kit quantitative detection of plasma BG levels. The results of 50 pg / mL as a positive cut-off value, BG detection sensitivity was 72.5%, specificity 91.4%, positive predictive value 90.6%, negative predictive value 74.4%. With a positive cutoff of 20 pg / mL, the sensitivity was 87.5%, the specificity was 88.6%, the positive predictive value was 89.7%, and the negative predictive value was 86.1%. BG can predict fungal infection from 1 to 10 days earlier than fungal culture with continuous monitoring. In BG-positive patients, 20 patients were treated with antifungal therapy, 19 were effective and 1 died. Anti-fungal treatment before BG levels showed a slow upward trend, maintained at a high level, anti-fungal treatment of patients with BG content showed a downward trend in patients with ineffective death was on the rise. Conclusion Plasma BG concentration is of great value in the early diagnosis and evaluation of IFI in patients with hematologic diseases and malignant tumors.