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目的探讨血浆(1-3)-β-D葡聚糖检测(G试验)对于尿路真菌感染的临床价值,同时分析尿路真菌感染的危险因素,为临床降低尿路真菌感染提供参考。方法选取2010年1月-2011年4月临床诊断为尿路真菌感染93例患者,81例非真菌感染者,52名健康体检者作为对照组,应用MB-80微生物动态快速检测系统和GKT-5MSet动态真菌检测试剂盒定量检测血浆(1-3)-β-D葡聚糖(BG)的含量,用ROC曲线评估G试验的诊断价值,同时用Kappa值检验G试验结果与培养结果的一致程度,用logistic回归建立模型进行危险因素分析。结果尿路真菌感染组BG 18.4pg/ml,显著高于非真菌组的7.5pg/ml和健康对照组的7.5pg/ml,ROC曲线分析显示,G试验临界值定为14.4pg/ml时,灵敏度、特异度、约登指数分别是91.00%、75.00%、0.66,可达最佳效果;G试验与培养一致性的Kappa值为0.583;单因素分析表明:中性粒细菌<0.5×109/L、长期使用广谱抗菌药物、BG含量与尿路真菌感染有相关性,多因素分析显示BG阳性、长期使用广谱抗菌药物为其预测因素。结论血浆BG可作为尿路真菌感染的早期预警指标,避免高危因素的发生,可有效减少尿路真菌感染的发生。
Objective To investigate the clinical value of plasma (1-3) -β-D-glucan test (G test) for the diagnosis of urinary tract fungal infection and to analyze the risk factors of urinary tract fungal infection for reference to reduce the urinary tract fungal infection. Methods From January 2010 to April 2011, 93 patients with urinary tract fungal infection, 81 non-fungal infections and 52 healthy controls were selected as the control group. MB-80 microbiological rapid detection system and GKT- The content of plasma (1-3) -β-D-glucan (BG) was quantitatively determined by 5 MSet dynamic fungus detection kit. The diagnostic value of G test was evaluated by ROC curve. The K test results were consistent with the results of G test Degree, using logistic regression to establish the model for risk factor analysis. Results The urinary tract fungal infection group BG18.4pg / ml, significantly higher than non-fungal group 7.5pg / ml and healthy control group 7.5pg / ml, ROC curve analysis showed that the G test cutoff value was 14.4pg / ml, The sensitivity, specificity and Youden index were 91.00%, 75.00% and 0.66, respectively, which reached the best effect. The Kappa value of G test and culture consistency was 0.583. The single factor analysis showed that the Neutrophil <0.5 × 109 / L, long-term use of broad-spectrum antibiotics, BG content and urinary tract fungal infections are related to multivariate analysis showed that BG-positive, long-term use of broad-spectrum antibiotics as a predictor. Conclusion Plasma BG can be used as an early warning indicator of urinary tract fungal infection, to avoid the occurrence of risk factors, can effectively reduce the incidence of urinary tract fungal infection.