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目的探讨血浆1,3-β-D葡聚糖用于诊断恶性血液病患者侵袭性真菌感染的临床价值。方法选取确诊或怀疑侵袭性真菌感染的恶性血液病患者418例及同期无真菌感染的恶性血液病患者366例。结果以≥50pg/ml为阳性诊断标准时BG结果阳性者334例,阳性率42.60%,以≥20pg/ml为阳性诊断标准时BG结果阳性者408例,阳性率52.04%,以≥20mg/ml为阳性标准时该试验的敏感性和阴性预测值均明显高于≥50pg/ml为阳性标准,两种标准之间差异有统计学意义(P<0.05);而两种标准的特异性和阳性预测值差异无统计学意义。结论通过1,3-β-D葡聚糖检测可以对恶性血液病患者侵袭性真菌感染进行早期诊断,而且医师可以根据经验以不同的阳性界值对其敏感性和特异性进行调节,即减少预防用药造成的毒性和增加的费用,又避免了侵袭性感染危及患者生命。
Objective To investigate the clinical value of plasma 1,3-β-D-glucan in the diagnosis of invasive fungal infection in patients with hematologic malignancies. Methods 418 cases of malignant hematological diseases diagnosed or suspected invasive fungal infection and 366 cases of hematological malignancies without fungal infection were enrolled in this study. The results of ≥ 50pg / ml positive diagnostic criteria for the BG results were positive in 334 cases, the positive rate of 42.60%, with ≥ 20pg / ml as the positive diagnostic criteria for the BG results were positive 408 cases, the positive rate of 52.04%, ≥ 20mg / ml was positive The sensitivity and negative predictive value of this test were significantly higher than the standard of ≥ 50pg / ml at the standard, the difference between the two standards was statistically significant (P <0.05); while the specificity and positive predictive value of the two standards difference No statistical significance. Conclusions The detection of invasive fungal infection in patients with hematologic malignancies can be diagnosed early by 1,3-β-D-glucan, and physicians can adjust their sensitivity and specificity by experience with different positive cutoffs, ie decrease Prevention of toxicity and increased costs caused by medication, but also to avoid invasive infections endanger the lives of patients.