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目的探讨实时荧光定量PCR与1,3-β-D葡聚糖试验(G试验)在儿童侵袭性肺部真菌感染诊断中的价值。方法对拟诊肺部真菌感染的31例患儿,取咽部吸出物做真菌培养、涂片,真菌、白色念珠菌PCR检测,取全血做G试验,比较检测的准确性。结果研究组31例中,白色念珠菌PCR检测阳性12例,G试验阳性15例。对照组11例标本PCR检测、G试验均阴性。PCR与G试验一致性检验结果显示两组间一致性中等(Kappa=0.512),研究组与对照组检测阳性率比较有统计学差异(P<0.05)。结论实时荧光定量PCR检测可用于儿童侵袭性肺部真菌感染的早期诊断,与G试验联合应用可提高诊断的敏感性。
Objective To investigate the value of real-time fluorescence quantitative PCR and 1,3-β-D-glucan test (G test) in the diagnosis of invasive pulmonary fungal infection in children. Methods Thirty-one children suspected of pulmonary fungal infection were enrolled in this study. Fungal culture, smear, fungi and Candida albicans PCR were performed on throat aspiration. The whole blood was taken as G test and the accuracy of the test was compared. Results 31 cases of study group, Candida albicans PCR test positive in 12 cases, G test was positive in 15 cases. The control group of 11 specimens PCR test, G test were negative. PCR and G test consistency test results showed that the consistency between the two groups (Kappa = 0.512), the positive rate of the test group and the control group was statistically significant (P <0.05). Conclusion Real-time PCR detection can be used for the early diagnosis of invasive pulmonary fungal infection in children, and combined with G test can improve the diagnostic sensitivity.