摘要
目的:探讨荧光定量PCR检测痰曲霉菌在慢性阻塞性肺疾病(COPD)患者侵袭性肺曲霉菌病(invasive pulmonary aspergillosis, IPA)中的诊断价值。方法:采用前瞻性观察性研究,入组2015年4月至2017年3月因COPD急性加重入住复旦大学附属中山医院的49例患者。收集患者常规痰液真菌培养后剩余的痰液,采用荧光定量PCR检测曲霉菌。同时分析患者的一般资料,包括临床症状、影像学资料、实验室检查结果。结果:49例患者中18例诊断为IPA,多见于全身应用糖皮质激素及广谱抗生素的患者。该病确诊较困难,多依赖临床诊断,荧光定量PCR检测痰液中曲霉菌在COPD患者合并IPA诊断中的敏感性和特异性分别为72.2%、87.1%。结论:COPD患者发生IPA并不少见,荧光定量PCR检测痰中曲霉菌对其具有早期诊断价值。
Objective:To investigate the diagnostic value of fluorescence quantitative polymerase chain reaction(PCR)in chronic obstructive pulmonary disease(COPD)combined with invasive pulmonary aspergillosis(IPA).Methods:A prospective observational study was conducted.From April 2015 to March 2017,49 patients admitted to the Zhongshan Hospital,Fudan University due to the acute exacerbation of COPD were enrolled.The remaining sputum from patients after conventional sputum fungal culture was collected and aspergillus was detected by fluorescence quantitative PCR.The clinical data was analyzed,including clinical symptom,imaging,and laboratorial results.Results:In the 49 patients,18 patients were diagnosed with IPA,most of them were prescribed with steroids and broad spectrum antibiotics.The diagnosis of the disease was difficult and depended mostly on clinical diagnosis.The sensitivity and specificity of PCR detection of aspergillus in sputum in the diagnosis of COPD patients combined with IPA was 72.2%and 87.1%,respectively.Conclusions:IPA is not uncommon in COPD patients.Detection of aspergillus in sputum by fluorescence quantitative PCR is of early diagnostic value.
作者
王琴
严梦楠
宋一祎
李华茵
WANG Qin;YAN Meng-nan;SONG Yi-yi;LI Hua-yin(Department of Respiratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中国临床医学》
2019年第2期238-241,共4页
Chinese Journal of Clinical Medicine
基金
上海市科学技术委员会项目(16411964300)~~
关键词
侵袭性肺曲霉菌病
慢性阻塞性肺病
诊断
invasive pulmonary aspergillosis
chronic obstructive pulmonary disease
diagnosis
