论文部分内容阅读
目的评价痰培养联合曲霉血清学半乳甘露聚糖(GM)试验对侵袭性曲霉感染的临床诊断价值。方法对济宁医学院附属医院2012年7月至2013年7月间疑似曲霉感染的216例住院患者进行痰培养和血清ELISA检测。以临床诊断为标准,评估痰培养和GM试验及联合检测的敏感性、特异性、阳性预测值和阴性预测值,采用2检验进行比较。应用受试者工作特征曲线(ROC曲线)比较不同检测的疾病识别能力。结果痰培养的敏感性和特异性为60.4%和69.9%,GM试验为94.3%和94.5%,二者联合检测可将诊断的敏感性和特异性分别提高至98.1%和99.4%。联合检测的ROC曲线下面积(AUC)为0.960,95%可信区间为0.929~0.992。结论痰真菌培养联合血清GM抗原检测能大幅提高曲霉感染病例的临床诊断效率。
Objective To evaluate the clinical diagnostic value of sputum culture combined with Aspergillus oryzae serogroup galactomannan (GM) on invasive Aspergillus infection. Methods Totally 216 inpatients with suspected Aspergillus infection in Jining Medical College Affiliated Hospital from July 2012 to July 2013 were tested for sputum culture and serum ELISA. Based on the clinical diagnosis, the sensitivity, specificity, positive predictive value and negative predictive value of sputum culture and GM test and combined test were evaluated and compared with 2 test. The receiver operating characteristic curve (ROC curve) was used to compare the disease detection capabilities of the different tests. Results The sensitivity and specificity of sputum culture were 60.4% and 69.9%, and the GM tests were 94.3% and 94.5% respectively. The combined detection of sputum and sputum increased the diagnostic sensitivity and specificity to 98.1% and 99.4% respectively. The area under the ROC curve (AUC) of the joint detection was 0.960, and the 95% confidence interval was 0.929-0.992. Conclusion Sputum fungal culture combined with serum GM antigen test can significantly improve the clinical diagnostic efficiency of aspergillosis cases.