支气管镜下肺泡灌洗液半乳甘露聚糖试验联合（1，3）-β-D葡聚糖检测对肺曲霉菌病 的诊断价值*

Diagnostic value of BALF GM test combined with G test under bronchoscope for pulmonary aspergillosis*

摘要:

探讨支气管镜下肺泡灌洗液（BALF）半乳甘露聚糖（GM）试验联合（1，3）-β-D葡聚糖检测（G试验）对肺曲霉菌病的诊断价值。方法 选取2013年5月－2016年12月在该院住院的30例确诊为肺曲霉菌病的患者作为研究对象，定为研究组，30例非真菌感染患者为对照组，所有患者均支气管镜下采集BALF，并同时采集血清标本进行GM试验和G试验，比较单独和联合试验的检测结果。结果 研究组中，BALF GM试验阳性21例，G试验阳性25例；血清GM试验阳性19例，G试验阳性23例；BALF GM联合G试验阳性27例；血清GM联合G试验阳性26例。BALF GM试验联合G试验检测灵敏度、特异性、阳性预测值、阴性预测值和准确度分别为90.0%、93.3%、93.1%、93.3%和91.0%。结论 支气管镜下BALF GM试验联合G试验检测对肺曲霉菌病的诊断临床价值高，可作为诊断肺曲霉菌病的重要辅助诊断手段。

Abstract:

?To investigate the diagnostic value of BALF GM test combined with G test under bronchoscope in the diagnosis of pulmonary aspergillosis.?Methods?30 patients with pulmonary aspergillosis from May 2013 to December 2016 were selected as study group and 30 patients with non-fungal infection were selected as control group. All the patients were collected from alveolar lavage fluid (BALF) under bronchoscope and serum samples were collected for galactomannan test (GM test) and 1, 3- β-D-glucan test (G test).?Results?In the study group, 21 cases were positive for GM test in alveolar lavage fluid, 25 cases were positive for G test, 19 cases were positive for serum GM test, 23 cases were positive for G test, 27 cases were positive for GM combined with G test in alveolar lavage fluid, and 26 cases were positive for serum GM combined G test; The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of bronchoalveolar lavage fluid GM test combined with G test were 90.0%, 93.3%, 93.1%, 93.3% and 91.0%, respectively.?Conclusion?BALF GM test combined with G test under bronchoscope is of high clinical value in the diagnosis of pulmonary aspergillosis and can be used as an important auxiliary diagnostic index for pulmonary aspergillosis.