摘要
目的分析血清l,3-β-D-葡聚糖(G)试验、半乳甘露聚糖(GM)试验、CT检查和三者联合检测对慢性阻塞性肺疾病(COPD)患者合并侵袭性肺曲霉菌感染(IPA)的诊断价值。方法收集2017年1月-2018年12月山东省菏泽市立医院呼吸科及重症监护室诊治COPD患者95例的临床资料,其中合并IPA组(COPD合并IPA)患者49例,单纯COPD组(COPD不合并IPA)患者46例,对患者均行血清G试验、GM试验、胸部CT检查,分析3种方法联合检测的诊断价值。结果 3种方法单独检测的敏感度均很低,特异度均较高。三者中两两比较,GM试验的敏感度较好,特异度三者相近(P>0.05);3种方法联合检测,较单独G试验、GM试验及CT检测的敏感度要高(χ^2=23.5、5.4、16.5,P均<0.05),但特异度略低,差异均无统计学意义(P>0.05)。结论 G试验、GM试验联合胸部CT检查能提高COPD患者中IPA诊断的敏感性和准确性,利于临床医生早期诊断COPD合并IPA。
Objective To analyze the diagnostic value of serum(1,3)-(3-D glucan(G)test,galactomannan(GM)test,CT examination and three combined tests in patients with chronic obstructive pulmonary disease(COPD)complicated with invasive pulmonary aspergillosis(IPA).Methods From January 2017 to December 2018,95 patients with COPD were diagnosed and treated in respiratory department and intensive care unit of Heze Municipal Hospital,Shandong Province.Among them,49 patients were treated with IPA combined with COPD,46 patients with IPA not combined with COPD alone.Serum G test,GM test and chest CT were performed on all patients,and three prescriptions were analyzed.The diagnostic value of the combined detection.Results The sensitivity of the three methods was low and the specificity was high.Among the three,the sensitivity of the GM test was better,and the specificity was similar(P>0.05).The combined detection of the three methods was more sensitive than the G test,GM test and CT test alone(χ~2=23.5,χ~2=5.4,χ~2 =16.5,P<0.05),but the specificity was slightly lower,the difference was not statistically significant(P>0.05).Conclusion The G test,GM test combined with chest CT examination can improve the sensitivity and accuracy of IPA diagnosis in COPD patients,which is conducive to early diagnosis of COPD combined with IPA by clinicians.
作者
徐瑞娥
李凤珍
邵建平
潘秋玉
董卫平
XU Ruie;LI Fengzhen;SHAO Jianping;PAN Qiuyu;DONG Weiping(Department of Respiration , Heze Municipal Hospital, Shandong Province, Heze 274007 , China)
出处
《疑难病杂志》
CAS
2019年第10期997-1001,共5页
Chinese Journal of Difficult and Complicated Cases
基金
山东省2016年科学技术研究发展计划项目(2016L041)
