[摘要] 目的 分析支气管肺泡灌洗液（BALF）半乳甘露聚糖（GM）试验结果与侵袭性肺曲霉菌培养阳性结果间的相关性。 方法 收集2014年1月～2016年12月浙江省650家医疗合作点（包括三级、二级和社区医院）8086例患有呼吸系统疾病住院患者的BALF，同时采集1459例患者血清；采用GM试剂盒，严格按照试剂盒说明书对BALF和血清样本进行GM试验，通过观察GM试验的I值结果分析对侵袭性肺曲霉菌病（IPA）的诊断价值及BALF结果分析IPA诊断符合率。用沙保弱培养基按常规方法进行真菌培养。曲霉菌鉴定：培养阳性的真菌经KOH制片，在显微镜下观察形态和颜色区分曲霉菌。 结果 8086例BALF曲霉菌培养阳性样本数为1193例。在曲霉菌阳性BALF样本中，GM试验I值 /6/view-10695944.htm
[关键词] 曲霉菌；肺泡灌洗液；半乳甘露聚糖；真菌鉴定
[中图分类号] R519 [文献标识码] A [文章编号] 1673-7210（2018）01（a）-0118-05
[Abstract] Objective To analyze the correlation between the results of galacto-mannan （GM） test in bronchoalveolar fluid （BALF） and the positive results of invasive pulmonary aspergillus. Methods From January 2014 to December 2016， 8086 BALF and 1459 serum from patients with respiratory disease in 650 cooperative medical institutions （including tertiary， secondary and community hospitals） in Zhejiang Province were collected. By using the GM test kits to carry out GM experiments in BALF and serum samples according to the instructions of the kit， the diagnostic value of the invasive pulmonary aspergillosis （IPA） was analyzed by the results of the I value， the IPA diagnosis compliance rate was analyzed with BALF results. Fungal culture was carried out in a conventional manner by using sand-fortified medium. Aspergillus identification： the fungal from the positive samples were cultured， so they could be subjected to 10% KOH based smear before microscopic observation， and then the Aspergillus were differentiated by their morphology and color. Results There were 1193 Aspergillus positive specimens among these 8086 BALF samples. In the Aspergillus positive samples， according to the results of I value of GM test： 2.1 for 870 （77.12%）； and in 5103 cases which had no fungal growth， the results of I value of GM test was： 2.1 for 277 cases. There was a significant difference between these two groups （P 1.8 统计学方法
采用SPSS 13.0统计学软件进行数据分析，按照厂家推荐标准，BALF和血清GM试验以待测标本的指数（I）≥0.5为诊断界值。采用四格表χ2检验分析GM试验的敏感性、特异性、阳性预测值和阴性预测值的差异，以P [参考文献]
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（收稿日期：2017-09-08 本文?辑：王 琼）
发表于 2018-8-14 21:21:12