The value of serum galactomannan detection for diagnosis of invasive aspergillosis in hematopoietic stem cell transplant recipients

目的 初步评价血清半乳甘露聚糖(GM)浓度测定对于造血干细胞移植后患者侵袭性曲霉菌感染(IA)的诊断价值.方法 采用双抗体夹心酶联免疫吸附分析(ELISA)法测定46例进行造血干细胞移植或移植后患者的167份血清样本的GM浓度,根据我国侵袭性真菌感染诊断标准,评价GM测定前后诊断的变化,并计算该诊断试验的各项评价指标.结果 按照试验中测定的界值,该诊断试验的灵敏度为81.8%,特异度为93.3%,阳性预测值为90.0%,阴性预测值为87.5%.GM测定阳性为15例,GM测定阴性为31例,通过GM测定临床诊断IA者由11例增加至19例,且GM浓度与患者疾病的预后具有相关性.结论 通过ELISA方法进行血清GM检测可以为早期诊断IA提供有力证据,是一项快速、较灵敏的诊断试验.To evaluate the value of serum galactomannan (GM) detection for diagnosis of invasive aspergillosis (IA) in hematopoietic stem cell transplant recipients.The serum GM concentration in 167 sera from 46 patients was detected by Platelia Aspergillus double-sandwich enzyme linked immunosorbent assay (PADSELISA). According to the diagnostic criteria of invasive fungal infections in China, the diagnostic changes were evaluated, the sensitivity, specificity and predictive values were calculated.The sensitivity and specificity of the PADSELISA were 81.8% and 93.3% and the positive and negative predictive values were 90.0% and 87.5% respectively. There were 15 positive cases, and 31 negative cases, and the probable IA cases were increased from 11 to 19 after the GM detection. Moreover, the serous level of galactomannan was correlated with the prognosis of the IA.The PADSELISA for GM detection is a reliable method for early diagnosis and treatment of IA in hematopoietic stem cell transplant recipients.教育部跨世纪优秀人才培养计划PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0283-862