GM试验联合CD4+T淋巴细胞诊断艾滋病患者侵袭性曲霉病的研究
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柳明波

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R519

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广西壮族自治区卫生厅自筹青年基金(Z2013746);广西医科大学青年科学基金(GXMUYSF201347)


Galactomannan test combined with CD4+T lymphocytes for the diagnosis of invasive aspergillosis in patients with AIDS
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    摘要:

    目的探讨半乳甘露聚糖(GM)试验联合CD4+T淋巴细胞检测对艾滋病(AIDS)患者合并侵袭性曲霉菌病(IA)的早期诊断价值。方法回顾性分析2014年1月—2016年12月某院住院怀疑IA的AIDS患者197例,分为确诊IA组(35例)、临床诊断IA组(疑似病例,96例)和非IA组(66例),比较GM试验、GM试验联合CD4+T淋巴细胞计数检测诊断IA的灵敏度和特异度。结果 确诊IA组、临床诊断IA组、非IA组患者GM值中位数(最小值,最大值)分别为1.29(0.65,1.84)、0.91(0.36,1.23)、0.11(0.28,0.72)pg/mL,CD4+T淋巴细胞计数分别为45(29,69)、79(35,99)、89(59,158)cell/μL,三组患者GM值和CD4+T淋巴细胞计数比较,差异均有统计学意义(均P<0.05)。单独GM试验诊断AIDS患者IA的灵敏度为64.9%,特异度为72.7%;1周内连续2次GM试验诊断AIDS患者IA的灵敏度为72.5%,特异度为95.5%;GM试验和CD4+T淋巴细胞联合检测的灵敏度为86.3%,特异度为90.9%。结论GM试验对AIDS 患者IA有较好的诊断价值,且连续行GM试验、GM试验联合CD4+T淋巴细胞计数检测将进一步提高IA临床诊断价值。

    Abstract:

    ObjectiveTo evaluate the effect of galactomannan(GM) test combined with CD4+ T lymphocyte detection on early diagnosis of invasive aspergillosis (IA) in patients with acquired immunodeficiency syndrome (AIDS).Methods197 AIDS patients who were suspected with IA in a hospital from January 2014 to December 2016 were analyzed retrospectively, they were divided into confirmed IA group (n=35), clinically diagnosed IA group (n=96, suspected cases), and nonIA group(n=66), sensitivity and specificity of GM test and GM test combined CD4+T lymphocyte counting for diagnosing IA were compared.ResultsIn confirmed IA group, clinically diagnosed IA group, and nonIA group, the medium values of GM (minimum, maximum) were 1.29(0.65,1.84)pg /mL, 0.91(0.36,1.23)pg /mL, and 0.11(0.28,0.72)pg /mL respectively, CD4+T lymphocyte counting were 45(29,69)cells/μL, 79(35,99)cells/μL, and 89(59,158)cells/μL respectively, GM value and CD4+T lymphocyte counting among three groups were significantly different(all P<0.05). The sensitivity and specificity of single GM test for diagnosing IA in AIDS patients were 64.9% and 72.7% respectively; sensitivity and specificity of two consecutive GM test within one week for diagnosing IA were 72.5% and 95.5% respectively; sensitivity and specificity of GM test combined CD4+T lymphocyte counting were 86.3% and 90.9% respectively.ConclusionGM test has better diagnostic value for IA in AIDS patients, continuous GM test and GM test combined CD4+ T lymphocyte counting will further improve the clinical diagnostic value for IA.

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柳明波,方霞,梁欣,等. GM试验联合CD4+T淋巴细胞诊断艾滋病患者侵袭性曲霉病的研究[J]. 中国感染控制杂志,2018,17(1):36-40. DOI:10.3969/j. issn.1671-9638.2018.01.008.
LIU Mingbo, FANG Xia, LIANG Xin, et al. Galactomannan test combined with CD4+T lymphocytes for the diagnosis of invasive aspergillosis in patients with AIDS[J]. Chin J Infect Control, 2018,17(1):36-40. DOI:10.3969/j. issn.1671-9638.2018.01.008.

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  • 收稿日期:2017-04-10
  • 最后修改日期:2017-06-22
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  • 在线发布日期: 2017-12-29
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