(1,3) -β-D 葡聚糖与半乳甘露聚糖联合检测对侵袭性曲霉菌感染的研究分析
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高文英,董海威,李永琦,耿丹,吴杉杉
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太原金域临床检验所有限公司,山西太原,030000
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摘要:目的 研究侵袭性曲霉菌感染(invasive aspergillosis,IA) 情况分析,为侵袭性曲霉菌的临床分析提供参考。方法 以2021 年10月至2022年9月送检太原金域临床检验所有限公司为侵袭性真菌感染(invasive fungal disease,IFD) 患者的标本557 例为研究对象,分析年龄、性别、科室、标本类型对IA 阳性检出结果的影响。结果 557例IFD患者中,检测出为IA阳性的患者为117例(19.75%)。IA阳性主要集中在0~9 岁、50~59 岁、≥ 60 岁年龄段人群,其阳性率分别为40.17%、27.35% 和14.53%。感染科室也主要是呼吸与危重症科39 例、重症科18 例 和儿科17 例,其阳性占比分别为33.33%、15.38% 和14.53%。IA 阳性患者主要患病的季节主要集中在夏秋季节,尤其是秋季(7 月~9 月);不同的标本类型对IA阳性的检出无统计学意义(P> 0.05)。结论 G试验和GM试验对IA有一定诊断价值,而联合检测大大提高了敏感性,对 IA 的诊断更有价值,利于临床医生早期诊断 IA。
关健词::(1,3) -β-D 葡聚糖;半乳甘露聚糖;侵袭性曲霉菌感染
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Analysis of Combined (1,3)-β-D-Glucan and Galactomannan Testing for Invasive Aspergillosis
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Wenying Gao,Haiwei Dong,Yongqi Li,Dan Geng,Shanshan Wu
Taiyuan KingMed Clinical Laboratory Co.,Ltd.,Taiyuan Shanxi 030000,China
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Abstract:Objective To study the status of invasive aspergillosis (IA) and provide a reference for its clinical analysis.Methods A total of 557 specimens from patients with invasive fungal disease (IFD), sent to Taiyuan KingMed Clinical Laboratory Co.,Ltd. between October 2021 and September 2022, were included as the study subjects. The effects of age, gender, department, and specimen type on positive IA detection results were analyzed.Results Among the 557 IFD patients, 117 (19.75%) tested positive for IA. IA positivity was primarily concentrated in the age groups of 0-9 years, 50-59 years, and ≥60 years, with positive rates of 40.17%, 27.35%, and 14.53%, respectively. The main departments with IA-positive cases were Respiratory and Critical Care Medicine (39 cases), Intensive Care Unit (18 cases), and Pediatrics (17 cases), accounting for 33.33%, 15.38%, and 14.53% of positive cases, respectively. IA-positive cases were predominantly identified during the summer and autumn seasons, especially in autumn (July to September). Different specimen types showed no statistically significant difference in the detection of IA positivity (P > 0.05).Conclusion The G-test and GM-test have certain diagnostic value for IA. However, combined testing significantly improves sensitivity, offers greater value for the diagnosis of IA, and is beneficial for clinicians in the early diagnosis of IA.
Keywords : (1,3)-β-D-glucan; Galactomannan; Invasive aspergillosis
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