单宇+刘军权+祝宇翀

    [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 < 0.01). There also was a significant difference between the Aspergillus positive group and the Candida positive group (P < 0.01). The analysis of I value of GM test in BALF and invasive pulmonary aspergillosis (IPA) diagnostic coincidence rate： When the I value was set to ≥2.1， the sensitivity， specificity， positive predictive value and negative predictive value of IPA diagnosis were as follows： 77.12% 94.57%， 76.86% and 76.85%， the differences were statistically significant (P < 0.01)； with the analysis thatwhen I value was set to be≥0.5 for positive results (94.89% ......